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Sample records for rapid cycling bipolar

  1. Rapid cycling bipolar disorder: clinical characteristics and treatment options.

    Science.gov (United States)

    Coryell, William

    2005-01-01

    Approximately one of six patients who seek treatment for bipolar disorder present with a rapid cycling pattern. In comparison with other patients who have bipolar disorder, these individuals experience more affective morbidity in both the immediate and distant future and are more likely to experience recurrences despite treatment with lithium or anticonvulsants. Particular care should be given to distinguishing rapid cycling bipolar disorder from attention-deficit hyperactivity disorder in children or adolescents and from borderline personality disorder in adults. Perhaps four of five cases of rapid cycling resolve within a year, but the pattern may persist for many years in the remaining patients. As with bipolar disorder in general, depressive symptoms produce the most morbidity over time. Controlled studies have not established that antidepressants provoke switching or rapid cycling, but neither have they been shown consistently to have benefits in bipolar illness. Successful management will often require a sequence of trials with mood stabilizer drugs, beginning with lithium in treatment-naive patients. Efforts to minimise adverse effects, and the recognition that full benefits may not be apparent for several months, will make the premature abandonment of a potentially helpful treatment less likely. Placebo-controlled studies so far provide the most support for the use of lithium and lamotrigine as prophylactic agents. The combination of lithium and carbamazepine, valproate or lamotrigine for maintenance has some support from controlled studies, as does the adjunctive use of olanzapine.

  2. Biological aspects and candidate biomarkers for rapid-cycling in bipolar disorder: A systematic review.

    Science.gov (United States)

    Buoli, Massimiliano; Serati, Marta; Altamura, A Carlo

    2017-12-01

    Rapid-cycling bipolar disorder represents a frequent severe subtype of illness which has been associated with poor response to pharmacological treatment. Aim of the present article is to provide an updated review of biological markers associated with rapid-cycling bipolar disorder. A research in the main database sources has been conducted to identify relevant papers about the topic. Rapid-cycling bipolar disorder patients seem to have a more frequent family history for bipolar spectrum disorders (d range: 0.44-0.74) as well as an increased susceptibility to DNA damage or mRNA hypo-transcription (d range: 0.78-1.67) than non rapid-cycling ones. A susceptibility to hypothyroidism, which is exacerbated by treatment with lithium, is possible in rapid-cycling bipolar disorder, but further studies are needed to draw definitive conclusions. Rapid-cycling bipolar patients might have more insuline resistance as well as more severe brain changes in frontal areas (d range: 0.82-0.94) than non rapid-cycling ones. Many questions are still open about this topic. The first is whether the rapid-cycling is inheritable or is more generally the manifestation of a severe form of bipolar disorder. The second is whether some endocrine dysfunctions (diabetes and hypothyroidism) predispose to rapid-cycling or rapid-cycling is the consequence of drug treatment or medical comorbidities (e.g. obesity). Copyright © 2017 Elsevier B.V. All rights reserved.

  3. [Rapid Cycling in Bipolar Disorders: Symptoms, Background and Treatment Recommendations].

    Science.gov (United States)

    Köhler, Stephan; Friedel, Eva; Stamm, Thomas

    2017-04-01

    Rapid cycling bipolar disorder is encountered frequently in clinical practice with a lifetime prevalence of up to 31 %. Besides its association with greater illness severity, increased suicide and comorbidity rates, rapid cycling bipolar disorder has been closely associated with a longer and more complicated course of disease and inadequate treatment response compared to non-rapid cycling bipolar disorder. However rapid cycling does not serve as a stable characteristic of bipolar disorder, though its prevalence increases with illness duration. Female gender, hypothyreoidism and antidepressant medications have been suggested as correlates of rapid cycling bipolar disorder; however, the interaction amongst these factors make an interpretation of their causal relations difficult. Only very few data are available from randomized clinical trials that investigated the therapeutic options of rapid cycling bipolar disorder. Based on these trials, the therapeutic outcome of lithium is similar to that of the class of anticonvulsants. Positive treatment outcome reported for atypical neuroleptics is often based on pharmaceutical company-financed, placebo-controlled RCTS. Altogether independent prospective RCTs and head-to-head comparisons are lacking that can provide sufficient information on treatment response. In addition, the role of antidepressant treatment in the course and phase acceleration of bipolar disorder remains insufficiently understood. However, in the light of present empirical evidence, the use of antidepressant medication in the treatment of rapid cycling bipolar disorder has to be looked at highly critically. © Georg Thieme Verlag KG Stuttgart · New York.

  4. Comparison of treatment outcome using two definitions of rapid cycling in subjects with bipolar II disorder.

    Science.gov (United States)

    Amsterdam, Jay D; Lorenzo-Luaces, Lorenzo; DeRubeis, Robert J

    2017-02-01

    We examined differences in treatment outcome between Diagnostic and Statistical Manual Fourth Edition (DSM-IV)-defined rapid cycling and average lifetime-defined rapid cycling in subjects with bipolar II disorder. We hypothesized that, compared with the DSM-IV definition, the average lifetime definition of rapid cycling may better identify subjects with a history of more mood lability and a greater likelihood of hypomanic symptom induction during long-term treatment. Subjects ≥18 years old with a bipolar II major depressive episode (n=129) were categorized into DSM-IV- and average lifetime-defined rapid cycling and prospectively treated with either venlafaxine or lithium monotherapy for 12 weeks. Responders (n=59) received continuation monotherapy for six additional months. These exploratory analyses found moderate agreement between the two rapid-cycling definitions (κ=0.56). The lifetime definition captured subjects with more chronic courses of bipolar II depression, whereas the DSM-IV definition captured subjects with more acute symptoms of hypomania. There was no difference between rapid-cycling definitions with respect to the response to acute venlafaxine or lithium monotherapy. However, the lifetime definition was slightly superior to the DSM-IV definition in identifying subjects who went on to experience hypomanic symptoms during continuation therapy. Although sample sizes were limited, the findings suggest that the lifetime definition of rapid cycling may identify individuals with a chronic rapid-cycling course and may also be slightly superior to the DSM-IV definition in identifying individuals with hypomania during relapse-prevention therapy. These findings are preliminary in nature and need replication in larger, prospective, bipolar II studies. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. Elevated levels of plasma brain derived neurotrophic factor in rapid cycling bipolar disorder patients

    DEFF Research Database (Denmark)

    Munkholm, Klaus; Pedersen, Bente Klarlund; Kessing, Lars Vedel

    2014-01-01

    Impaired neuroplasticity may be implicated in the pathophysiology of bipolar disorder, involving peripheral alterations of the neurotrophins brain derived neurotrophic factor (BDNF) and neurotrophin 3 (NT-3). Evidence is limited by methodological issues and is based primarily on case-control desi......Impaired neuroplasticity may be implicated in the pathophysiology of bipolar disorder, involving peripheral alterations of the neurotrophins brain derived neurotrophic factor (BDNF) and neurotrophin 3 (NT-3). Evidence is limited by methodological issues and is based primarily on case...... were measured in 37 rapid cycling bipolar disorder patients and in 40 age- and gender matched healthy control subjects using enzyme-linked immunosorbent assay (ELISA). In a longitudinal design, repeated measurements of BDNF and NT-3 were evaluated in various affective states in bipolar disorder...

  6. Mood Oscillations and Coupling Between Mood and Weather in Patients with Rapid Cycling Bipolar Disorder

    OpenAIRE

    Boker, Steven M.; Leibenluft, Ellen; Deboeck, Pascal R.; Virk, Gagan; Postolache, Teodor T.

    2008-01-01

    Rapid Cycling Bipolar Disorder (RCBD) outpatients completed twice-daily mood self-ratings for 3 consecutive months. These ratings were matched with local measurements of atmospheric pressure, cloud cover, and temperature. Several alternative second order differential equation models were fit to the data in which mood oscillations in RCBD were allowed to be linearly coupled with daily weather patterns. The modeling results were consistent with an account of mood regulation that included intrin...

  7. Rapid Cycling and Its Treatment

    Science.gov (United States)

    ... Announcements Public Service Announcements Partnering with DBSA Rapid Cycling and its Treatment What is bipolar disorder? Bipolar ... to Depression and Manic Depression . What is rapid cycling? Rapid cycling is defined as four or more ...

  8. Obesity and obstetric complications are associated with rapid-cycling in Italian patients with bipolar disorder.

    Science.gov (United States)

    Buoli, Massimiliano; Dell'Osso, Bernardo; Caldiroli, Alice; Carnevali, Greta Silvia; Serati, Marta; Suppes, Trisha; Ketter, Terence A; Altamura, A Carlo

    2017-01-15

    Rapid cycling (RC) worsens the course of bipolar disorder (BD) being associated with poor response to pharmacotherapy. Previous studies identified clinical variables potentially associated with RCBD: however, in many cases, results were discordant or unreplicated. The present study was aimed to compare clinical variables between RC and non RC bipolar patients and to identify related risk factors. A sample of 238 bipolar patients was enrolled from 3 different community mental health centers. Descriptive analyses were performed on total sample, and patients were compared in terms of socio-demographic and clinical variables according to the presence of RC by multivariate analyses of variance (MANOVAs, continuous variables) or χ2 tests (qualitative variables). Binary logistic regression was performed to calculate odds ratios. Twenty-eight patients (11.8%) had RC. The two groups were not different in terms of age, age at onset, gender distribution, type of family history, type of substance use disorder, history of antidepressant therapy, main antidepressant, psychotic symptoms, comorbid anxiety disorders, suicide attempts, thyroid diseases, diabetes, type of BD, duration of untreated illness, illness duration, duration of antidepressant treatment and GAF scores. In contrast, RC patients had more often a history of obstetric complications (pobesity (pobesity and obstetric complications are risk factors for the development of RC in BD. In addition, lifetime MDMA misuse may be more frequent in RC bipolar patients. Copyright © 2016 Elsevier B.V. All rights reserved.

  9. Relationship between social rhythms and mood in patients with rapid cycling bipolar disorder.

    Science.gov (United States)

    Ashman, S B; Monk, T H; Kupfer, D J; Clark, C H; Myers, F S; Frank, E; Leibenluft

    1999-04-19

    Disruptions in the sleep-wake cycle frequently characterize affective illness and have led to a number of theories linking sleep-wake and/or circadian rhythm disturbance to affective illness. Recently, researchers have expanded these chronobiological theories to include the role of lifestyle regularity, or daily social rhythms. In this study, the Social Rhythm Metric (SRM) was used to explore the relationship between social rhythms and mood in patients with rapid cycling bipolar disorder and to compare the social rhythms of patients with those of healthy control subjects. Patients' SRM scores and activity level indices were significantly lower than those of control subjects. In addition, the timing of five, mostly morning, activities was phase delayed in patients compared to control subjects. Patients also demonstrated a phase delay in the timing of morning activities during depression compared to hypomania or euthymia. The phase changes in the timing of morning activities are consistent with other data implicating morning zeitgebers in the pathophysiology of rapid cycling bipolar disorder.

  10. Elevated levels of IL-6 and IL-18 in manic and hypomanic states in rapid cycling bipolar disorder patients

    DEFF Research Database (Denmark)

    Munkholm, Klaus; Weikop, Pia; Kessing, Lars Vedel

    2015-01-01

    obtained in affective states of varying polarity during 6-12 months in 37 rapid cycling bipolar disorder patients and compared with repeated measurements in 40 age- and gender matched healthy control subjects, using rigorous laboratory-, clinical- and statistical methodology. Adjusting for demographical...

  11. Remission of classic rapid cycling bipolar disorder with levothyroxine augmentation therapy in a male patient having clinical hypothyroidism

    Directory of Open Access Journals (Sweden)

    Chen PH

    2015-02-01

    Full Text Available Pao-Huan Chen, Yu-Jui Huang Department of Psychiatry, Taipei Medical University Hospital, Taipei, Taiwan Abstract: The literature suggests that patients with bipolar disorder, particularly females, have greater vulnerability to rapid cycling features. Levothyroxine therapy might be potentially useful to attenuate mood instability in this patient group. In contrast, reports on male patients remain limited and controversial. Herein, we report a 32-year-old male patient who had bipolar 1 disorder for 12 years who developed a breakthrough rapid cycling course and first-onset clinical hypothyroidism at the age of 31 years during lithium therapy. After levothyroxine augmentation therapy was introduced, the patient had remission from the rapid cycling illness course along with normalization of serum levels of free T4 and thyroid stimulating hormone in the subsequent year. This observation suggested that investigation of both levothyroxine pharmacology and thyroid pathology in male patients with rapid cycling bipolar disorder might be of much value. Keywords: mood disorder, therapy, thyroid hormone

  12. Mood Oscillations and Coupling Between Mood and Weather in Patients with Rapid Cycling Bipolar Disorder.

    Science.gov (United States)

    Boker, Steven M; Leibenluft, Ellen; Deboeck, Pascal R; Virk, Gagan; Postolache, Teodor T

    2008-01-01

    Rapid Cycling Bipolar Disorder (RCBD) outpatients completed twice-daily mood self-ratings for 3 consecutive months. These ratings were matched with local measurements of atmospheric pressure, cloud cover, and temperature. Several alternative second order differential equation models were fit to the data in which mood oscillations in RCBD were allowed to be linearly coupled with daily weather patterns. The modeling results were consistent with an account of mood regulation that included intrinsic homeostatic regulation as well as coupling between weather and mood. Models were tested first in a nomothetic method where models were fit over all individuals and fit statistics of each model compared to one another. Since substantial individual differences in intrinsic dynamics were observed, the models were next fit using an ideographic method where each individual's data were fit separately and best-fitting models identified. The best-fitting within-individual model for the largest number of individuals was also the best-fitting nomothetic model: temperature and the first derivative of temperature coupled to mood and no effect of barometric pressure or cloud cover. But this model was not the best-fitting model for all individuals, suggesting that there may be substantial individual differences in the dynamic association between weather and mood in RCBD patients. Heterogeneity in the parameters of the differential equation model of homeostatic equilibrium as well as the coupling of mood to an inherently unpredictable (i.e., nonstationary) process such as weather provide an alternative account for reported broadband frequency spectra of daily mood in RCBD.

  13. Mood Oscillations and Coupling Between Mood and Weather in Patients with Rapid Cycling Bipolar Disorder

    Science.gov (United States)

    Boker, Steven M.; Leibenluft, Ellen; Deboeck, Pascal R.; Virk, Gagan; Postolache, Teodor T.

    2008-01-01

    Rapid Cycling Bipolar Disorder (RCBD) outpatients completed twice-daily mood self-ratings for 3 consecutive months. These ratings were matched with local measurements of atmospheric pressure, cloud cover, and temperature. Several alternative second order differential equation models were fit to the data in which mood oscillations in RCBD were allowed to be linearly coupled with daily weather patterns. The modeling results were consistent with an account of mood regulation that included intrinsic homeostatic regulation as well as coupling between weather and mood. Models were tested first in a nomothetic method where models were fit over all individuals and fit statistics of each model compared to one another. Since substantial individual differences in intrinsic dynamics were observed, the models were next fit using an ideographic method where each individual’s data were fit separately and best-fitting models identified. The best-fitting within-individual model for the largest number of individuals was also the best-fitting nomothetic model: temperature and the first derivative of temperature coupled to mood and no effect of barometric pressure or cloud cover. But this model was not the best-fitting model for all individuals, suggesting that there may be substantial individual differences in the dynamic association between weather and mood in RCBD patients. Heterogeneity in the parameters of the differential equation model of homeostatic equilibrium as well as the coupling of mood to an inherently unpredictable (i.e., nonstationary) process such as weather provide an alternative account for reported broadband frequency spectra of daily mood in RCBD. PMID:19266057

  14. Sex differences in the risk of rapid cycling and other indicators of adverse illness course in patients with bipolar I and II disorder.

    Science.gov (United States)

    Erol, Almila; Winham, Stacey J; McElroy, Susan L; Frye, Mark A; Prieto, Miguel L; Cuellar-Barboza, Alfredo B; Fuentes, Manuel; Geske, Jennifer; Mori, Nicole; Biernacka, Joanna M; Bobo, William V

    2015-09-01

    To examine the independent effects of sex on the risk of rapid cycling and other indicators of adverse illness course in patients with bipolar I disorder (BP-I) or bipolar II disorder (BP-II). We analyzed data from the first 1,225 patients enrolled in the Mayo Clinic Individualized Medicine Biobank for Bipolar Disorder. Demographic and clinical variables were ascertained using standardized questionnaires; height and weight were assessed to determine body mass index (BMI). Rates of rapid cycling, cycle acceleration, and increased severity of mood episodes over time were compared between women and men overall and within subgroups defined by bipolar disorder subtype (BP-I or BP-II). Multiple logistic regression analysis was used to assess the independent effect of sex on the risk of these indicators of adverse illness course. Women had significantly higher rates of rapid cycling than men. Overall rates of rapid cycling were higher in patients with BP-II than BP-I; and sex differences in the rate of rapid cycling were more pronounced in patients with BP-II than BP-I, although the power to detect statistically significant differences was reduced due to the lower sample size of subjects with BP-II. Female sex was a significant predictor of rapid cycling, cycle acceleration, and increased severity of mood episodes over time after adjusting for age, bipolar disorder subtype, BMI, having any comorbid psychiatric disorder, and current antidepressant use. Female sex was associated with significantly higher risk of rapid cycling, cycle acceleration, and increased severity of mood episodes over time in a sample of 1,225 patients with bipolar disorders. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Anti-AMPA-Receptor Encephalitis Presenting as a Rapid-Cycling Bipolar Disorder in a Young Woman with Turner Syndrome.

    Science.gov (United States)

    Quaranta, Giuseppe; Maremmani, Angelo Giovanni Icro; Perugi, Giulio

    2015-01-01

    Background. Autoimmune encephalitis is a disorder characterised by the subacute onset of seizures, short-term memory loss, and psychiatric and behavioural symptoms. Initially, it was recognised as a paraneoplastic disorder, but recently a subgroup of patients without systemic cancer was identified. Case Description. We describe a 20-year-old woman with Turner syndrome presenting with a treatment-resistant rapid cycling bipolar disorder with cognitive impairment. She was diagnosed with anti-AMPA-receptor encephalitis. She showed marked improvement after starting memantine and valproic acid. Conclusion. This case description emphasises the importance of timely recognition of autoimmune limbic encephalitis in patients with psychiatric manifestations and a possible predisposition to autoimmune conditions, in order to rule out malignancy and to quickly initiate treatment.

  16. A double-blind, placebo-controlled, prophylaxis study of lamotrigine in rapid-cycling bipolar disorder. Lamictal 614 Study Group.

    Science.gov (United States)

    Calabrese, J R; Suppes, T; Bowden, C L; Sachs, G S; Swann, A C; McElroy, S L; Kusumakar, V; Ascher, J A; Earl, N L; Greene, P L; Monaghan, E T

    2000-11-01

    Patients with rapid-cycling bipolar disorder are often treatment refractory. This study examined lamotrigine as maintenance monotherapy for rapid-cycling bipolar disorder. Lamotrigine was added to patients' current psychotropic regimens and titrated to clinical effect during an open-label treatment phase. Stabilized patients were tapered off other psychotropics and randomly assigned to lamotrigine or placebo monotherapy for 6 months. Time to additional pharmacotherapy for emerging symptoms was the primary outcome measure. Secondary efficacy measures included survival in study (time to any premature discontinuation), percentage of patients stable without relapse for 6 months, and changes in the Global Assessment Scale and Clinical Global Impressions-Severity scale. Safety was assessed from adverse event, physical examination, and laboratory data. 324 patients with rapid-cycling bipolar disorder (DSM-IV criteria) received open-label lamotrigine, and 182 patients were randomly assigned to the double-blind maintenance phase. The difference between the treatment groups in time to additional pharmacotherapy did not achieve statistical significance in the overall efficacy population. However, survival in study was statistically different between the treatment groups (p = .036). Analyses also indicated a 6-week difference in median survival time favoring lamotrigine. Forty-one percent of lamotrigine patients versus 26% of placebo patients (p = .03) were stable without relapse for 6 months of monotherapy. Lamotrigine was well tolerated; there were no treatment-related changes in laboratory parameters, vital signs, or body weight. No serious rashes occurred. This was the largest and only prospective placebo-controlled study of rapid-cycling bipolar disorder patients to date; results indicate lamotrigine monotherapy is a useful treatment for some patients with rapid-cycling bipolar disorder.

  17. Independent Predictors for Lifetime and Recent Substance Use Disorders in Patients with Rapid Cycling Bipolar Disorder: Focus on Anxiety Disorders

    Science.gov (United States)

    Gao, Keming; Chan, Philip K.; Verduin, Marcia L.; Kemp, David E.; Tolliver, Bryan K.; Ganocy, Stephen J.; Bilali, Sarah; Brady, Kathleen T.; Findling, Robert L.; Calabrese, Joseph R.

    2010-01-01

    We set out to study independent predictor(s) for lifetime and recent substance use disorder (SUDs) in patients with rapid cycling bipolar disorder (RCBD). Extensive Clinical Interview and Mini International Neuropsychiatric Interview were used to ascertain DSM-IV Axis I diagnoses of RCBD, anxiety disorders, and SUDs. Data from patients enrolling into four similar clinical trials were used. Where appropriate, univariate analyses with t-test or Chi-Square were applied. Stepwise logistic regression was used to examine the relationship among predictor variables and lifetime and recent SUDs. Univariate analysis showed that patients with co-occurring anxiety disorders (n=261) had significantly increased rates of lifetime (OR=2.1) and recent (OR=1.9) alcohol dependence as well as lifetime (OR=3.4) and recent (OR=2.5) marijuana dependence compared to those without co-occurring anxiety disorder (n=303). In logistic regression analyses, generalized anxiety disorder (GAD) was associated with increased risk for lifetime SUDs (OR=2.34), alcohol dependence (OR=1.73), and marijuana dependence (OR=3.36), and recent marijuana dependence (OR=3.28). A history of physical abuse was associated with increased risk for lifetime SUDs (OR=1.71) and recent marijuana dependence (OR=3.47). Earlier onset of first mania/hypomania was associated with increased risk for lifetime SUDs (5% per year) and recent marijuana dependence (12% per year) and later treatment with a mood stabilizer were also associated with increased risk for recent SUDs (8% per year). Positive associations between generalized anxiety disorder, later treatment with a mood stabilizer, and early childhood trauma and history of SUDs suggests that adequate treatment of comorbid anxiety, early treatment with a mood stabilizer, and prevention of childhood trauma may reduce the risk for the development of SUDs in patients with bipolar disorder. PMID:20716307

  18. Clinical correlates of patients with rapid-cycling bipolar disorder and a recent history of substance use disorder: a subtype comparison from baseline data of 2 randomized, placebo-controlled trials.

    Science.gov (United States)

    Gao, Keming; Verduin, Marcia L; Kemp, David E; Tolliver, Bryan K; Ganocy, Stephen J; Elhaj, Omar; Bilali, Sarah; Brady, Kathleen T; Findling, Robert L; Calabrese, Joseph R

    2008-07-01

    To compare clinical variables in patients with rapid-cycling bipolar I or II disorder and a recent history of substance use disorder (SUD). Cross-sectional data from 2 studies of patients with rapid-cycling bipolar I disorder or rapid-cycling bipolar II disorder and a recent history of SUD were used to retrospectively assess the differences in clinical variables between the subtypes. The studies were conducted from November 1997 to February 2007 at University Hospitals Case Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio. Extensive clinical interview and the Mini-International Neuropsychiatric Interview were used to ascertain DSM-IV diagnoses of rapid-cycling bipolar disorder, SUDs, and other Axis I disorders and to collect clinical variables. The Addiction Severity Index (ASI), Global Assessment Scale (GAS), and the Medical Outcomes Study 36-Item Short-Form Health Survey were used to measure the severity of impairment at the initial assessment. One-way analysis of variance or chi(2) was used for significance tests. A Bonferroni adjustment was applied for multiple comparisons. Of 245 patients with rapid-cycling bipolar disorder (rapid-cycling bipolar I disorder, N = 191; rapid-cycling bipolar II disorder, N = 54) and a recent history of SUD, the demographics were similar. A significantly higher rate of panic disorder was observed in patients with rapid-cycling bipolar I disorder than in those with rapid-cycling bipolar II disorder (odds ratio = 3.72, 95% CI = 1.66 to 8.32, p = .008). A significantly higher psychiatric composite score on the ASI was also found in patients with rapid-cycling bipolar I disorder than in those with rapid-cycling bipolar II disorder even after Bonferroni adjustment (p = .0007). There were no significant differences between the subtypes in the rates of previous hospitalization or suicide attempt, early childhood verbal, physical, or sexual abuse, lifetime substance abuse or dependence, the number of

  19. Reduced mRNA expression of PTGDS in peripheral blood mononuclear cells of rapid-cycling bipolar disorder patients compared with healthy control subjects

    DEFF Research Database (Denmark)

    Munkholm, Klaus; Peijs, Lone; Kessing, Lars Vedel

    2015-01-01

    that mRNA expression of PTGDS and AKR1C3 is deregulated in rapid-cycling disorder patients in a euthymic or current affective state compared with healthy control subjects, and that expression alters with affective states. METHODS: PTGDS and AKR1C3 mRNA expression in peripheral blood mononuclear cells......BACKGROUND: Disturbances related to the arachidonic acid cascade and prostaglandin metabolism may be involved in the pathophysiology of bipolar disorder, as supported by a recent genome-wide association study meta-analysis; however, evidence from clinical studies on a transcriptional level...... was measured in 37 rapid-cycling bipolar disorder patients and 40 age- and gender-matched healthy control subjects using reverse transcription quantitative real-time polymerase chain reaction. Repeated measurements of PTGDS and AKR1C3 mRNA expression were obtained in various affective states during 6-12 months...

  20. Saccadic performance and cortical excitability as trait-markers and state-markers in rapid-cycling bipolar disorder: a 2-case follow-up study.

    Directory of Open Access Journals (Sweden)

    Jennifer eMalsert

    2013-01-01

    Full Text Available Background: The understanding of physiopathology and cognitive impairments in mood disorders requires finding objective markers. Mood disorders have often been linked to hypometabolism in the prefrontal dorsolateral cortex, and to GABAergic and glutamatergic neurotransmission dysfunction. The present study aimed to discover whether saccadic tasks (involving DPLFC activity, and cortical excitability (involving GABA/Glutamate neurotransmission could provide neuropsychophysical markers for mood disorders, and/or of its phases, in patients with rapid-cycling bipolar disorders (rcBD. Methods: Two rcBD patients were followed for a cycle, and were compared to 9 healthy controls. A saccade task, mixing prosaccades, antisaccades and nosaccades, and an evaluation of cortical excitability using transcranial magnetic stimulation were performed. Results: We observed a deficit in antisaccade in patients independently of thymic phase, and in nosaccade in the manic phase only. Cortical excitability data revealed global intracortical deficits in all phases, switching according to cerebral hemisphere and thymic phase. Conclusion: Specific patterns of performance in saccade tasks and cortical excitability could characterize mood disorders (trait-markers and its phases (state-markers. Moreover, a functional relationship between oculometric performance and cortical excitability is discussed.

  1. Comorbid anxiety and substance use disorders associated with a lower use of mood stabilisers in patients with rapid cycling bipolar disorder: a descriptive analysis of the cross-sectional data of 566 patients.

    Science.gov (United States)

    Gao, K; Kemp, D E; Conroy, C; Ganocy, S J; Findling, R L; Calabrese, J R

    2010-02-01

    To study mood stabiliser treatment in patients with bipolar disorder with or without anxiety disorders (ADs) and/or substance use disorders (SUDs). Extensive clinical interview and Mini-International Neuropsychiatric Interview were used to ascertain DSM-IV diagnoses of rapid cycling bipolar I (RCBDI) or II (RCBDII), SUDs and ADs. Previous treatment statuses with a mood stabiliser after the first onset of mania/hypomania (unmedicated, mismedicated and correctly medicated) were retrospectively determined in patients enrolled into four similar clinical trials. T-test and chi-square/Fisher's exact were used wherever appropriate. Of 566 patients (RCBDI n = 320, RCBDII n = 246), 46% had any lifetime AD, 67% had any lifetime SUD and 40% had any recent SUD. Overall, 12% of patients were unmedicated, 37% were mismedicated at the onset of first mania/hypomania and 51% were correctly medicated. Presence of lifetime ADs and recent SUDs was associated with fewer mood stabiliser treatments. Patients with RCBDI were more likely correctly medicated than those with RCBDII (OR = 3.64) regardless of the presence (OR = 2.6) or absence (OR = 4.2) of ADs, or the presence (OR = 2.8) or absence (OR = 3.13) of recent SUDs. Presence of lifetime ADs and recent SUDs increased the risk for mismedicated in RCBDI with odds ratios of 1.8 and 1.9, respectively, but not in RCBDII. In this multi-morbid cohort of patients with RCBD, 51% of patients (64% of RCBDI and 33% with RCDBII) were correctly medicated with a mood stabiliser after the onset of first mania/hypomania. The presence of ADs and SUDs was associated with an increased risk of mismedicated in patients with RCBDI, but not with RCBDII.

  2. The bipolarity of light and dark: A review on Bipolar Disorder and circadian cycles.

    Science.gov (United States)

    Abreu, T; Bragança, M

    2015-10-01

    Bipolar Disorder is characterized by episodes running the full mood spectrum, from mania to depression. Between mood episodes, residual symptoms remain, as sleep alterations, circadian cycle disturbances, emotional deregulation, cognitive impairment and increased risk for comorbidities. The present review intends to reflect about the most recent and relevant information concerning the biunivocal relation between bipolar disorder and circadian cycles. It was conducted a literature search on PubMed database using the search terms "bipolar", "circadian", "melatonin", "cortisol", "body temperature", "Clock gene", "Bmal1 gene", "Per gene", "Cry gene", "GSK3β", "chronotype", "light therapy", "dark therapy", "sleep deprivation", "lithum" and "agomelatine". Search results were manually reviewed, and pertinent studies were selected for inclusion as appropriate. Several studies support the relationship between bipolar disorder and circadian cycles, discussing alterations in melatonin, body temperature and cortisol rhythms; disruption of sleep/wake cycle; variations of clock genes; and chronotype. Some therapeutics for bipolar disorder directed to the circadian cycles disturbances are also discussed, including lithium carbonate, agomelatine, light therapy, dark therapy, sleep deprivation and interpersonal and social rhythm therapy. This review provides a summary of an extensive research for the relevant literature on this theme, not a patient-wise meta-analysis. In the future, it is essential to achieve a better understanding of the relation between bipolar disorder and the circadian system. It is required to establish new treatment protocols, combining psychotherapy, therapies targeting the circadian rhythms and the latest drugs, in order to reduce the risk of relapse and improve affective behaviour. Copyright © 2015 Elsevier B.V. All rights reserved.

  3. A role for prostaglandins in rapid cycling suggested by episode-specific gene expression shifts in peripheral blood mononuclear cells

    DEFF Research Database (Denmark)

    Gurvich, Artem; Begemann, Martin; Dahm, Liane

    2014-01-01

    OBJECTIVES: Over 12% of patients with bipolar disorder exhibit rapid cycling. The underlying biological mechanisms of this extreme form of bipolar disease are still unknown. This study aimed at replicating and extending findings of our previously published case report, where an involvement of pro...

  4. Rapid clozapine titration in treatment-refractory bipolar disorder.

    Science.gov (United States)

    Ifteni, Petru; Correll, Christoph U; Nielsen, Jimmi; Burtea, Victoria; Kane, John M; Manu, Peter

    2014-09-01

    Clozapine is effective in treatment-refractory bipolar disorder (BD). Guidelines recommend slow titration to prevent seizures, hypotension and myocarditis, but this stance is not supported by comparative data. To evaluate the safety and effectiveness of rapid clozapine titration in BD. Analysis of a consecutive cohort of treatment-refractory BD patients with mixed/manic episode admitted on alternate days to one of two units of a psychiatric hospital. On one unit, clozapine was started at 25mg followed by 25-50mg as needed every 6h (maximum=100mg/day) on day 1, followed by increases of 25-100mg/day. On the other unit, clozapine was initiated with 25mg in day 1, followed by increases of 25-50mg/day. The primary outcome was the number of days from starting clozapine until readiness for discharge, adjusted in logistic regression for the number of antipsychotics tried during the hospitalization, psychotropic co-treatments and presence of psychotic features. Patients subject to rapid (N=44) and standard (N=23) titration were similar in age, gender, smoking status, body mass index, illness severity at baseline and discharge, and highest clozapine dose. Clozapine was discontinued due to hypotension (N=1) and pneumonia (N=1) during rapid titration, and for excessive sedation (N=1) in each titration group. The number of hospital days from starting clozapine until readiness for discharge was 3.8 days shorter in the rapid titration group (12.7±6.3 vs. 16.5±5.8, p=0.0077). Rapid clozapine titration appeared safe and effective for treatment-refractory BD. The potential for shorter hospital stays justifies prospective trials of this method. Copyright © 2014 Elsevier B.V. All rights reserved.

  5. Rapid Update Cycle (RUC) [20 km

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Rapid Update Cycle (RUC) weather forecast model was developed by the National Centers for Environmental Prediction (NCEP). On May 1, 2012, the RUC was replaced...

  6. Rapid Update Cycle (RUC) [13 km

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Rapid Update Cycle (RUC) weather forecast model was developed by the National Centers for Environmental Prediction (NCEP). On May 1, 2012, the RUC was replaced...

  7. Rapid-Cycling Bubble-Chamber, details

    CERN Multimedia

    CERN PhotoLab

    1980-01-01

    Parts of the hydraulic expansion system of the Rapid-Cycling Bubble-Chamber (RCBC). RCBC was the largest of 3 rapid-cycling bubble-chambers (the others were LEBC and HOLEBC), used as target- and vertex-detectors within the European Hybrid Spectrometer (EHS) in the SPS North Area (EHN1). RCBC contained 250 l of liquid hydrogen and was located inside a 3 T superconducting magnet. It was designed for 30 expansions/s (100 times faster than BEBC), the system shown here allowed 50 expansions/s. RCBC operated from 1981 to 1983 for experiments NA21, NA22 and NA23 at a rate of 15 expansions/s, clocking up a total of over 4 million. In the rear, at left, is bearded Lucien Veillet; Augustin Didona is at the right. See also 8001009. The installation of the piston assembly in the RCBC chamber body is shown in the Annual Report 1980, p.65.

  8. Methods and compositions for rapid thermal cycling

    Science.gov (United States)

    Beer, Neil Reginald; Benett, William J.; Frank, James M.; Deotte, Joshua R.; Spadaccini, Christopher

    2015-10-27

    The rapid thermal cycling of a material is targeted. A microfluidic heat exchanger with an internal porous medium is coupled to tanks containing cold fluid and hot fluid. Fluid flows alternately from the cold tank and the hot tank into the porous medium, cooling and heating samples contained in the microfluidic heat exchanger's sample wells. A valve may be coupled to the tanks and a pump, and switching the position of the valve may switch the source and direction of fluid flowing through the porous medium. A controller may control the switching of valve positions based on the temperature of the samples and determined temperature thresholds. A sample tray for containing samples to be thermally cycled may be used in conjunction with the thermal cycling system. A surface or internal electrical heater may aid in heating the samples, or may replace the necessity for the hot tank.

  9. Self-induced redox cycling coupled luminescence on nanopore recessed disk-multiscale bipolar electrodes.

    Science.gov (United States)

    Ma, Chaoxiong; Zaino Iii, Lawrence P; Bohn, Paul W

    2015-05-01

    We present a new configuration for coupling fluorescence microscopy and voltammetry using self-induced redox cycling for ultrasensitive electrochemical measurements. An array of nanopores, each supporting a recessed disk electrode separated by 100 nm in depth from a planar multiscale bipolar top electrode, was fabricated using multilayer deposition, nanosphere lithography, and reactive-ion etching. Self-induced redox cycling was induced on the disk electrode producing ∼30× current amplification, which was independently confirmed by measuring induced electrogenerated chemiluminescence from Ru(bpy)32/3+/tri-n-propylamine on the floating bipolar electrode. In this design, redox cycling occurs between the recessed disk and the top planar portion of a macroscopic thin film bipolar electrode in each nanopore. Electron transfer also occurs on a remote (mm-distance) portion of the planar bipolar electrode to maintain electroneutrality. This couples the electrochemical reactions of the target redox pair in the nanopore array with a reporter, such as a potential-switchable fluorescent indicator, in the cell at the distal end of the bipolar electrode. Oxidation or reduction of reversible analytes on the disk electrodes were accompanied by reduction or oxidation, respectively, on the nanopore portion of the bipolar electrode and then monitored by the accompanying oxidation of dihydroresorufin or reduction of resorufin at the remote end of the bipolar electrode, respectively. In both cases, changes in fluorescence intensity were triggered by the reaction of the target couple on the disk electrode, while recovery was largely governed by diffusion of the fluorescent indicator. Reduction of 1 nM of Ru(NH3)63+ on the nanoelectrode array was detected by monitoring the fluorescence intensity of resorufin, demonstrating high sensitivity fluorescence-mediated electrochemical sensing coupled to self-induced redox cycling.

  10. A limit cycle oscillator model for cycling mood variations of bipolar disorder patients derived from cellular biochemical reaction equations

    Science.gov (United States)

    Frank, T. D.

    2013-08-01

    We derive a nonlinear limit cycle model for oscillatory mood variations as observed in patients with cycling bipolar disorder. To this end, we consider two signaling pathways leading to the activation of two enzymes that play a key role for cellular and neural processes. We model pathway cross-talk in terms of an inhibitory impact of the first pathway on the second and an excitatory impact of the second on the first. The model also involves a negative feedback loop (inhibitory self-regulation) for the first pathway and a positive feedback loop (excitatory self-regulation) for the second pathway. We demonstrate that due to the cross-talk the biochemical dynamics is described by an oscillator equation. Under disease-free conditions the oscillatory system exhibits a stable fixed point. The breakdown of the self-inhibition of the first pathway at higher concentration levels is studied by means of a scalar control parameter ξ, where ξ equal to zero refers to intact self-inhibition at all concentration levels. Under certain conditions, stable limit cycle solutions emerge at critical parameter values of ξ larger than zero. These oscillations mimic pathological cycling mood variations that emerge due to a disease-induced bifurcation. Consequently, our modeling analysis supports the notion of bipolar disorder as a dynamical disease. In addition, our study establishes a connection between mechanistic biochemical modeling of bipolar disorder and phenomenological nonlinear oscillator approaches to bipolar disorder suggested in the literature.

  11. Quadrupole magnet for a rapid cycling synchrotron

    Energy Technology Data Exchange (ETDEWEB)

    Witte, H. [Brookhaven National Lab. (BNL), Upton, NY (United States); Berg, J. S. [Brookhaven National Lab. (BNL), Upton, NY (United States)

    2015-05-03

    Rapid Cycling Synchrotrons (RCS) feature interleaved warm and cold dipole magnets; the field of the warm magnets is used to modulate the average bending field depending on the particle energy. It has been shown that RCS can be an attractive option for fast acceleration of particles, for example, muons, which decay quickly. In previous studies it was demonstrated that in principle warm dipole magnets can be designed which can provide the required ramp rates, which are equivalent to frequencies of about 1 kHz. To reduce the losses it is beneficial to employ two separate materials for the yoke; it was also shown that by employing an optimized excitation coil geometry the eddy current losses are acceptable. In this paper we show that the same principles can be applied to quadrupole magnets targeting 30 T/m with a repetition rate of 1kHz and good field quality.

  12. Patients With Co-Occurring Bipolar Disorder and Posttraumatic Stress Disorder: A Rapid Review of the Literature.

    Science.gov (United States)

    Cerimele, Joseph M; Bauer, Amy M; Fortney, John C; Bauer, Mark S

    2017-05-01

    To summarize the current literature on epidemiology, clinical correlates, and treatment of individuals with co-occurring bipolar disorder and posttraumatic stress disorder (PTSD). We conducted a focused, time-sensitive review called "rapid review" in November 2015, using keyword searches (including keywords bipolar disorder, post-traumatic stress disorder, PTSD, and others) in PubMed for studies of adults with co-occurring bipolar disorder and PTSD. Results were sorted and systematically searched. An article was excluded if it did not describe adult patients with co-occurring PTSD and bipolar disorder or did not report original data on epidemiology, clinical correlates, or treatment. Information on study characteristics including population studied and key findings were extracted onto a data collection tool. Thirty-two articles were included. Over two-thirds of articles reported epidemiology of co-occurring bipolar disorder and PTSD. Prevalence of PTSD among individuals with bipolar disorder ranged from 4% to 40%, with women and those with bipolar I versus bipolar II disorder experiencing higher prevalence of PTSD. Prevalence of bipolar disorder among individuals with PTSD ranged from 6% to 55%. Baseline PTSD or bipolar disorder was associated with incidence of the other illness. Individuals with co-occurring bipolar disorder and PTSD experienced high symptom burden and low quality of life. No studies evaluated prospective treatment of patients with co-occurring bipolar disorder and PTSD. Bipolar disorder and PTSD commonly co-occur and result in greater symptom burden than either condition alone. Few published treatment strategies exist for patients with both conditions.

  13. Recent advances in sleep-wake cycle and biological rhythms in bipolar disorder.

    Science.gov (United States)

    Robillard, Rébecca; Naismith, Sharon L; Hickie, Ian B

    2013-10-01

    The cyclical nature of periodic switches in energy, motor activation and sleep-wake cycles in bipolar disorder suggests a strong underlying relationship with disturbances in chronobiology. Current research is refining our understanding of the various patterns of sleep-wake and biological rhythms alterations at early and later stages of this illness, as well as across its depressive/fatigue, manic/hypomanic and euthymic phases. This research focuses on early detection and subsequent monitoring to predict and better manage recurrent episodes. Sleep-wake cycle and biological rhythms disturbances are also well known to affect other key aspects of physical health (notably metabolic functions), cognitive performance and elevated risks for suicide. Increasing evidence now supports the integration of behavioural or pharmacological therapeutic strategies that target the sleep-wake and circadian systems in the ongoing treatment of various phases of bipolar disorder.

  14. Full cycle rapid scan EPR deconvolution algorithm

    Science.gov (United States)

    Tseytlin, Mark

    2017-08-01

    Rapid scan electron paramagnetic resonance (RS EPR) is a continuous-wave (CW) method that combines narrowband excitation and broadband detection. Sinusoidal magnetic field scans that span the entire EPR spectrum cause electron spin excitations twice during the scan period. Periodic transient RS signals are digitized and time-averaged. Deconvolution of absorption spectrum from the measured full-cycle signal is an ill-posed problem that does not have a stable solution because the magnetic field passes the same EPR line twice per sinusoidal scan during up- and down-field passages. As a result, RS signals consist of two contributions that need to be separated and postprocessed individually. Deconvolution of either of the contributions is a well-posed problem that has a stable solution. The current version of the RS EPR algorithm solves the separation problem by cutting the full-scan signal into two half-period pieces. This imposes a constraint on the experiment; the EPR signal must completely decay by the end of each half-scan in order to not be truncated. The constraint limits the maximum scan frequency and, therefore, the RS signal-to-noise gain. Faster scans permit the use of higher excitation powers without saturating the spin system, translating into a higher EPR sensitivity. A stable, full-scan algorithm is described in this paper that does not require truncation of the periodic response. This algorithm utilizes the additive property of linear systems: the response to a sum of two inputs is equal the sum of responses to each of the inputs separately. Based on this property, the mathematical model for CW RS EPR can be replaced by that of a sum of two independent full-cycle pulsed field-modulated experiments. In each of these experiments, the excitation power equals to zero during either up- or down-field scan. The full-cycle algorithm permits approaching the upper theoretical scan frequency limit; the transient spin system response must decay within the scan

  15. Variation in response to short-term antidepressant treatment between patients with continuous and non-continuous cycling bipolar disorders.

    Science.gov (United States)

    Tundo, Antonio; Calabrese, Joseph R; Proietti, Luca; de Fillippis, Rocco

    2015-03-15

    The study aimed to compare effectiveness and safety of short-term antidepressant treatment between patients with continuous (CCC) and non-continuous (N-CCC) cycling bipolar disorders. The study sample included 101 patients with bipolar disorder, 22 (21.8%) CCC and 79 (78.2%) N-CCC. Response was defined as a HDRS21 total score bipolar disorders with different response not only to prophylactic treatment, as previously reported, but also to short-term ADs. We submit that clinicians should take into consideration their patients׳ pattern of cycling when prescribing short-term AD treatment. Moreover, subtypes of bipolar disorders might be used as moderators of treatment response in studies assessing the efficacy or the effectiveness of antidepressant treatment. Copyright © 2014 Elsevier B.V. All rights reserved.

  16. A pilot study differentiating recurrent major depression from bipolar disorder cycling on the depressive pole

    Directory of Open Access Journals (Sweden)

    Marty Hinz

    2010-11-01

    Full Text Available Marty Hinz1, Alvin Stein2, Thomas Uncini31Clinical Research, NeuroResearch Clinics, Inc., Cape Coral, FL, USA; 2Stein Orthopedic Associates, Plantation, FL, USA; 3DBS Labs, Duluth, MN, USAPurpose: A novel method for differentiating and treating bipolar disorder cycling on the depressive pole from patients who are suffering a major depressive episode is explored in this work. To confirm the diagnosis of type 1 or type 2 bipolar disorder, the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV criteria require that at least one manic or hypomanic episode be identified. History of one or more manic or hypomanic episodes may be impossible to obtain, representing a potential blind spot in the DSM-IV diagnostic criteria. Many bipolar patients who cycle primarily on the depressive side for many years carry a misdiagnosis of recurrent major depression, leading to treatment with antidepressants that achieve little or no relief of symptoms. This article discusses a novel approach for diagnosing and treating patients with bipolar disorder cycling on the depressive pole versus patients with recurrent major depression.Patients and methods: Patients involved in this study were formally diagnosed with recurrent major depression under DSM-IV criteria and had no medical history of mania or hypomania to support the diagnosis of bipolar disorder. All patients had suffered multiple depression treatment failures in the past, when evaluated under DSM-IV guidelines, secondary to administration of antidepressant drugs and/or serotonin with dopamine amino acid precursors.Results: This study contained 1600 patients who were diagnosed with recurrent major depression under the DSM-IV criteria. All patients had no medical history of mania or hypomania. All patients experienced no relief of depression symptoms on level 3 amino acid dosing values of the amino acid precursor dosing protocol. Of 1600 patients studied, 117 (7.3% nonresponder patients were identified

  17. Rapid cycling genomic selection in a multiparental tropical maize population

    Science.gov (United States)

    Genomic selection (GS) increases genetic gain by reducing the length of the selection cycle, as has been exemplified in maize using rapid cycling recombination of biparental populations. However, no results of GS applied to maize multi-parental populations have been reported so far. This study is th...

  18. Rapid infusion of esketamine for unipolar and bipolar depression: a retrospective chart review

    Directory of Open Access Journals (Sweden)

    Correia-Melo FS

    2017-06-01

    Full Text Available Fernanda S Correia-Melo,1 Felipe C Argolo,1 Lucas Araújo-de-Freitas,1,2 Gustavo Carneiro Leal,1 Flávio Kapczinski,3 Acioly Luiz Lacerda,4 Lucas C Quarantini1,2 1Psychiatry Service, University Hospital, Federal University of Bahia, Salvador, Brazil; 2Postgraduate Program in Medicine and Health, Federal University of Bahia, Salvador, Brazil; 3Department of Psychiatry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil; 4Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil Background: This study evaluated efficacy and safety of intravenous subanesthetic doses of esketamine using an administration time of 10 minutes in patients with treatment-resistant depression and bipolar depression.Methods: A retrospective chart review was conducted to identify patients who met the inclusion criteria for treatment-resistant depression and bipolar depression according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria, and these patients received rapid infusion of esketamine between June 2012 and December 2015. The Montgomery–Åsberg Depression Rating Scale (MADRS was administered to measure and score depressive symptom severity before infusion and at 24 hours, 72 hours, and 7 days after infusion. In addition, Clinical Global Impression scale was administered before and 7 days after esketamine infusion.Results: Esketamine was administered to 30 patients. A total of 27 patients met the inclusion criteria and had MADRS evaluation data, which showed that 23 had unipolar and 4 had bipolar depression. Thirteen patients (48.1% showed therapeutic response (MADRS reduction ≥50% within 1 week (7 days of intervention. Remission (MADRS <7 was observed in 10 patients (37.0% in the same period. Therapeutic response and remission frequencies were seen in 16 (59.3% and 11 (40.7% patients, respectively, within 24 hours following drug infusion. The most relevant side effect observed during

  19. Reactive bipolar pulsed dual magnetron sputtering of ZrN films: The effect of duty cycle

    Science.gov (United States)

    Rizzo, A.; Valerini, D.; Capodieci, L.; Mirenghi, L.; Di Benedetto, F.; Protopapa, M. L.

    2018-01-01

    Zirconium nitride (ZrN) coatings, due to their inherent high hardness, wear and corrosion resistance, as well as the golden color, can be attractive for a wide range of applications, such as mechanical, optical, decorative and biomedical devices. Reactive Bipolar Pulsed Dual Magnetron Sputtering (BPDMS) operating in mid-frequency range is a powerful technique for the deposition of dense coatings, free from morphological defects, at high deposition rate. In fact, the use of mid-frequency voltage reversals allows suppressing arcs and, as a consequence, stabilizing the reactive sputtering process. Despite the success of the dual bipolar process, there are many aspects of this complex process that are not yet well understood, such as the influence of the target voltage waveforms and plasma parameters on the film growth. In order to fill this lack of knowledge, ZrN films were deposited by BPDMS with different voltage waveforms on the Zr targets and the influence of these deposition parameters on the films' stoichiometry as well as on their structural and mechanical properties is investigated in this paper. In particular, it was found that, for duty cycle values below 33%, the hardness of the coating increases up to 31 GPa. The analysis of the chemical composition, performed by XPS, detects an almost constant value of stoichiometry along the depth-profile of each film and the N:Zr ratio increases from 1.06 to 1.20 as the duty cycle decreases. Therefore, when the N:Zr ratio is 1.06 we got a stoichiometric ZrN compound, while for N:Zr equal to 1.20 we obtained a lack of Zr atoms with respect to N atoms. Raman spectroscopy confirms the results of XPS analyzes, since it showed some features related to the structural disorder in the sample grown with the lowest duty cycle.

  20. Rapid Cycling Genomic Selection in a Multiparental Tropical Maize Population

    Directory of Open Access Journals (Sweden)

    Xuecai Zhang

    2017-07-01

    Full Text Available Genomic selection (GS increases genetic gain by reducing the length of the selection cycle, as has been exemplified in maize using rapid cycling recombination of biparental populations. However, no results of GS applied to maize multi-parental populations have been reported so far. This study is the first to show realized genetic gains of rapid cycling genomic selection (RCGS for four recombination cycles in a multi-parental tropical maize population. Eighteen elite tropical maize lines were intercrossed twice, and self-pollinated once, to form the cycle 0 (C0 training population. A total of 1000 ear-to-row C0 families was genotyped with 955,690 genotyping-by-sequencing SNP markers; their testcrosses were phenotyped at four optimal locations in Mexico to form the training population. Individuals from families with the best plant types, maturity, and grain yield were selected and intermated to form RCGS cycle 1 (C1. Predictions of the genotyped individuals forming cycle C1 were made, and the best predicted grain yielders were selected as parents of C2; this was repeated for more cycles (C2, C3, and C4, thereby achieving two cycles per year. Multi-environment trials of individuals from populations C0, C1, C2, C3, and C4, together with four benchmark checks were evaluated at two locations in Mexico. Results indicated that realized grain yield from C1 to C4 reached 0.225 ton ha−1 per cycle, which is equivalent to 0.100 ton ha−1 yr−1 over a 4.5-yr breeding period from the initial cross to the last cycle. Compared with the original 18 parents used to form cycle 0 (C0, genetic diversity narrowed only slightly during the last GS cycles (C3 and C4. Results indicate that, in tropical maize multi-parental breeding populations, RCGS can be an effective breeding strategy for simultaneously conserving genetic diversity and achieving high genetic gains in a short period of time.

  1. Are antidepressants safe in the treatment of bipolar depression? A critical evaluation of their potential risk to induce switch into mania or cycle acceleration

    NARCIS (Netherlands)

    Licht, R. W.; Gijsman, H.; Nolen, W. A.; Angst, J.

    2008-01-01

    Objective: To address whether switch of depression into hypomania or mania or cycle acceleration in patients with bipolar disorder is caused by antidepressants or whether this phenomenon is attributable to the natural history of bipolar disorder itself. Method: A critical review of the literature,

  2. Rapid cycling medical synchrotron and beam delivery system

    Science.gov (United States)

    Peggs, Stephen G [Port Jefferson, NY; Brennan, J Michael [East Northport, NY; Tuozzolo, Joseph E [Sayville, NY; Zaltsman, Alexander [Commack, NY

    2008-10-07

    A medical synchrotron which cycles rapidly in order to accelerate particles for delivery in a beam therapy system. The synchrotron generally includes a radiofrequency (RF) cavity for accelerating the particles as a beam and a plurality of combined function magnets arranged in a ring. Each of the combined function magnets performs two functions. The first function of the combined function magnet is to bend the particle beam along an orbital path around the ring. The second function of the combined function magnet is to focus or defocus the particle beam as it travels around the path. The radiofrequency (RF) cavity is a ferrite loaded cavity adapted for high speed frequency swings for rapid cycling acceleration of the particles.

  3. Bipolar Affective Disorder and Parkinson's Disease

    Directory of Open Access Journals (Sweden)

    Birk Engmann

    2011-01-01

    Full Text Available Little is known about comorbidities of bipolar disorder such as Parkinson's disease. A case history and a literature survey indicate that bipolar disorder is linked with or influences Parkinson's disease and vice versa. Underlying mechanisms are poorly understood, and, more importantly, no treatment options are established in such double diagnoses. The few data in comorbid Parkinson cases seem to point to a rapid cycling pattern of bipolar symptoms. With regard to therapeutic intervention, the literature supports pramipexole for treatment of both Parkinson and depressive symptoms in bipolar depression. Lithium, the mood stabilizer of choice for treating manic states, is problematical for use in Parkinson patients because of its side effects. Valproate might be an alternative, especially for treatment of rapid cycling.

  4. Thyroid Functions and Bipolar Affective Disorder

    Directory of Open Access Journals (Sweden)

    Subho Chakrabarti

    2011-01-01

    Full Text Available Accumulating evidence suggests that hypothalamo-pituitary-thyroid (HPT axis dysfunction is relevant to the pathophysiology and clinical course of bipolar affective disorder. Hypothyroidism, either overt or more commonly subclinical, appears to the commonest abnormality found in bipolar disorder. The prevalence of thyroid dysfunction is also likely to be greater among patients with rapid cycling and other refractory forms of the disorder. Lithium-treatment has potent antithyroid effects and can induce hypothyroidism or exacerbate a preexisting hypothyroid state. Even minor perturbations of the HPT axis may affect the outcome of bipolar disorder, necessitating careful monitoring of thyroid functions of patients on treatment. Supplementation with high dose thyroxine can be considered in some patients with treatment-refractory bipolar disorder. Neurotransmitter, neuroimaging, and genetic studies have begun to provide clues, which could lead to an improved understanding of the thyroid-bipolar disorder connection, and more optimal ways of managing this potentially disabling condition.

  5. Space-Charge Simulation of Integrable Rapid Cycling Synchrotron

    Energy Technology Data Exchange (ETDEWEB)

    Eldred, Jeffery [Fermilab; Valishev, Alexander [Fermilab

    2017-05-01

    Integrable optics is an innovation in particle accelerator design that enables strong nonlinear focusing without generating parametric resonances. We use a Synergia space-charge simulation to investigate the application of integrable optics to a high-intensity hadron ring that could replace the Fermilab Booster. We find that incorporating integrability into the design suppresses the beam halo generated by a mismatched KV beam. Our integrable rapid cycling synchrotron (iRCS) design includes other features of modern ring design such as low momentum compaction factor and harmonically canceling sextupoles. Experimental tests of high-intensity beams in integrable lattices will take place over the next several years at the Fermilab Integrable Optics Test Accelerator (IOTA) and the University of Maryland Electron Ring (UMER).

  6. [Treatment of bipolar disorder].

    Science.gov (United States)

    Barde, Michael; Bellivier, Frank

    2014-11-01

    Bipolar disorder is a chronic pathology whose management must lead to limit the social, professional and family impacts as well as suicidal risk. The treatment of acute episodes and prophylaxis is based on mood stabilizer treatments whose lithium is a leader. They will be chosen according to the background and history of the disease. Anti-depressants must be used with care to minimize the risk of manic episode and the induction of rapid cycles. The prognosis is not solving major episodes but avoiding major mood episodes. The management of residual symptoms (especially neuro-cognitive) is also a major challenge prognosis and justifies the implementation of adjuvant psychotherapeutic strategies.

  7. New isolated gate bipolar transistor two-quadrant chopper power supply for a fast field cycling nuclear magnetic resonance spectrometer

    Science.gov (United States)

    Sousa, D. M.; Marques, G. D.; Sebastião, P. J.; Ribeiro, A. C.

    2003-10-01

    This work, presents, for the first time, an Isolated Gate Bipolar Transistor (IGBT) two-quadrant chopper power supply for a fast field cycling (FFC) nuclear magnetic resonance spectrometer. This power supply was designed to achieve a maximum current of 200 A with good efficiency, low semiconductor losses, low cost, and easy maintenance. Both energy storage circuits and dumping circuits are used to obtain switching times less than 2 ms between field levels in agreement with the FFC technique specifications. The current ripple at high currents is better than 1×10-4 and presents a specific shape which can be used for additional compensation using auxiliary circuits. The implemented power supply was tested and been continuously operating with a home-built FFC solenoidal magnet, associated cooling system, and rf units for fields between 0 and 0.2 T.

  8. Rapid Cycle Amine (RCA) 3.0 System Development

    Science.gov (United States)

    Chullen, Cinda; Campbell, Colin; Papale, William; Hawes, Kevin; Wichowski, Robert

    2015-01-01

    The Rapid Cycle Amine (RCA) 3.0 system is currently under development by NASA, the Lyndon B. Johnson Space Center (JSC) in conjunction with United Technologies Corporation Aerospace Systems (UTAS). The RCA technology is a new carbon dioxide (CO2) and humidity removal system that has been baselined for the Advanced Extravehicular Mobility Unit (AEMU) Portable Life Support System. The evolution of the RCA development has progressed through several iterations of technology readiness levels including RCA 1.0, RCA 2.0, and RCA 3.0 test articles. The RCA is an advancement over currently technologies due to its unique regeneration capability. The RCA is capable of simultaneously removing CO2 and humidity from an influent air steam and subsequent regeneration when exposed to a vacuum source. The RCA technology uses two solid amine sorbent beds in an alternating fashion to adsorb CO2 and water (uptake mode) and desorb CO2 and water (regeneration mode) at the same time. The two beds operate in an efficient manner so that while one bed is in the uptake mode, the other is in the regeneration mode, thus continuously providing an on-service sorbent bed by which CO2 and humidity may be removed. The RCA 2.0 and 3.0 test articles were designed with a novel valve assembly which allows for switching between uptake and regeneration modes with only one moving part while minimizing gas volume losses to the vacuum source by means of an internal pressure equalization step during actuation. The RCA technology also is low power, small, and has performed extremely well in all development testing thus far. A final design was selected for the RCA 3.0, fabricated, assembled, and performance tested in 2014 with delivery to NASAJSC in January 2015. This paper will provide an overview on the RCA 3.0 system design and results of pre-delivery testing with references to the development of RCA 1.0 and RCA 2.0.

  9. Plant Growth and Development: An Outline for a Unit Structured Around the Life Cycle of Rapid-Cycling Brassica Rapa.

    Science.gov (United States)

    Becker, Wayne M.

    This outline is intended for use in a unit of 10-12 lectures on plant growth and development at the introductory undergraduate level as part of a course on organismal biology. The series of lecture outlines is structured around the life cycle of rapid-cycling Brassica rapa (RCBr). The unit begins with three introductory lectures on general plant…

  10. Association of AIDS and Bipolar Mania with Rapid Progression to Dementia and Death

    Directory of Open Access Journals (Sweden)

    Chin-Yi Yang

    2005-02-01

    Full Text Available Neuropsychiatric complications of human immunodeficiency virus (HIV infection or acquired immune deficiency syndrome (AIDS may present clinically as acute or chronic organic brain syndrome, or mimic functional psychiatric diseases. Among such psychiatric diseases, mania tends to occur with increased frequency after the onset of AIDS. We report a case in which manic manifestations were noted before the diagnosis of AIDS. The patient had no past or family history of mood disorders, but had risk factors for HIV infection. He had a rapid downhill course from initial manic symptoms to depression, dementia and then death within 10 months. Such rapid cognitive deterioration into AIDS dementia after mania is consistent with previous reports. Cases like this will become more common with spread of the AIDS pandemic in Asian regions, including Taiwan. Clinicians should be mindful of HIV infection/AIDS as a differential diagnosis in patients with manic episodes and risk factors for HIV infection.

  11. Rapid-fire improvement with short-cycle kaizen.

    Science.gov (United States)

    Heard, E

    1999-05-01

    Continuous improvement is an attractive idea, but it is typically more myth than reality. SCK is no myth. It delivers dramatic improvements in traditional measures quickly. SCK accomplishes this via kaizens: rapid, repeated, time-compressed changes for the better in bite-sized chunks of the business.

  12. CLPX NOAA FSL Rapid Update Cycle 20 km (RUC-20) Dataset, Version 1

    Data.gov (United States)

    National Aeronautics and Space Administration — The Rapid Update Cycle analysis/model system at a 20-km horizontal resolution (RUC20) provides short-range numerical weather guidance for general forecasting, as...

  13. CLPX-Model: Rapid Update Cycle 40km (RUC-40) Model Output Reduced Data, Version 1

    Data.gov (United States)

    National Aeronautics and Space Administration — The Rapid Update Cycle, version 2 at 40km (RUC-2, known to the Cold Land Processes community as RUC40) model is a Mesoscale Analysis and Prediction System (MAPS)...

  14. CLPX NOAA FSL Rapid Update Cycle 20 km (RUC-20) Dataset

    Data.gov (United States)

    National Aeronautics and Space Administration — The Rapid Update Cycle analysis/model system at a 20-km horizontal resolution (RUC20) provides short-range numerical weather guidance for general forecasting, as...

  15. CLPX-Model: Rapid Update Cycle 40km (RUC-40) Model Output Reduced Data

    Data.gov (United States)

    National Aeronautics and Space Administration — The Rapid Update Cycle, version 2 at 40km (RUC-2, known to the Cold Land Processes community as RUC40) model is a Mesoscale Analysis and Prediction System (MAPS)...

  16. Nucleation of superconductivity under rapid cycling of an electric field

    Science.gov (United States)

    Bandyopadhyay, Malay

    2008-10-01

    The effect of an externally applied high-frequency oscillating electric field on the critical nucleation field of superconductivity in the bulk as well as at the surface of a superconductor is investigated in detail in this work. Starting from the linearized time-dependent Ginzburg-Landau (TDLG) theory, and using the variational principle, I have shown the analogy between a quantum harmonic oscillator with that of the nucleation of superconductivity in the bulk and a quantum double oscillator with that of the nucleation at the surface of a finite sample. The effective Hamiltonian approach of Cook et al (1985 Phys. Rev. A 31 564) is employed to incorporate the effect of an externally applied highly oscillating electric field. The critical nucleation field ratio is also calculated from the ground state energy method. The results obtained from these two approximate theories agree very well with the exact results for the case of an undriven system, which establishes the validity of these two approximate theories. It is observed that the highly oscillating electric field actually increases the bulk critical nucleation field (Hc2) as well as the surface critical nucleation field (Hc3) of superconductivity as compared to the case of absent electric field (ɛ0 = 0). But the externally applied rapidly oscillating electric field accentuates the surface critical nucleation field more than the bulk critical nucleation field, i.e. the increase of Hc3 is 1.6592 times larger than that of Hc2.

  17. Addressing the need for rapid treatment of agitation in schizophrenia and bipolar disorder: focus on inhaled loxapine as an alternative to injectable agents

    Directory of Open Access Journals (Sweden)

    Citrome L

    2013-05-01

    Full Text Available Leslie CitromeDepartment of Psychiatry and Behavioral Sciences, New York Medical College, Valhalla, NY, USAAbstract: Agitation (excessive motor or verbal activity can be associated with schizophrenia or bipolar mania, and can further escalate into aggressive behavior and potentially lead to injuries in patients and staff. Medications used to treat agitation include antipsychotics and benzodiazepines, usually administered intramuscularly when rapid action is desired. Loxapine, a first-generation antipsychotic, has recently been reformulated into an inhaled powder that allows for direct administration to the lungs, resulting in rapid absorption into the systemic circulation. Administered via a single-use device, inhaled loxapine was tested in randomized controlled trials in agitation associated with schizophrenia or bipolar mania; doses of 5 mg and 10 mg were found to be efficacious, with an apparent dose response. In the Phase III studies, number needed to treat versus placebo for a ≥40% reduction from baseline on the Positive and Negative Syndrome Scale – Excited Component (PANSS-EC at 2 hours was three for patients with bipolar disorder, and five for 5 mg and four for 10 mg for patients with schizophrenia, with effect sizes comparable to what has been observed in analogous studies of intramuscular injection of antipsychotics or lorazepam. Separation from placebo on the PANSS-EC was as early as 10 minutes postinhalation, the first time point where this was measured. Dysgeusia was the most commonly encountered spontaneously reported adverse event. Adverse events related to extrapyramidal symptoms and akathisia were relatively rare. Spirometry studies identified the potential for bronchospasm particularly in persons with asthma. Because of concerns over pulmonary safety, inhaled loxapine is restricted to use in hospitals and patients need to be prescreened for the presence of pulmonary disease, as well as monitored for signs and symptoms of

  18. Rapid cycling of reactive nitrogen in the marine boundary layer.

    Science.gov (United States)

    Ye, Chunxiang; Zhou, Xianliang; Pu, Dennis; Stutz, Jochen; Festa, James; Spolaor, Max; Tsai, Catalina; Cantrell, Christopher; Mauldin, Roy L; Campos, Teresa; Weinheimer, Andrew; Hornbrook, Rebecca S; Apel, Eric C; Guenther, Alex; Kaser, Lisa; Yuan, Bin; Karl, Thomas; Haggerty, Julie; Hall, Samuel; Ullmann, Kirk; Smith, James N; Ortega, John; Knote, Christoph

    2016-04-28

    Nitrogen oxides are essential for the formation of secondary atmospheric aerosols and of atmospheric oxidants such as ozone and the hydroxyl radical, which controls the self-cleansing capacity of the atmosphere. Nitric acid, a major oxidation product of nitrogen oxides, has traditionally been considered to be a permanent sink of nitrogen oxides. However, model studies predict higher ratios of nitric acid to nitrogen oxides in the troposphere than are observed. A 'renoxification' process that recycles nitric acid into nitrogen oxides has been proposed to reconcile observations with model studies, but the mechanisms responsible for this process remain uncertain. Here we present data from an aircraft measurement campaign over the North Atlantic Ocean and find evidence for rapid recycling of nitric acid to nitrous acid and nitrogen oxides in the clean marine boundary layer via particulate nitrate photolysis. Laboratory experiments further demonstrate the photolysis of particulate nitrate collected on filters at a rate more than two orders of magnitude greater than that of gaseous nitric acid, with nitrous acid as the main product. Box model calculations based on the Master Chemical Mechanism suggest that particulate nitrate photolysis mainly sustains the observed levels of nitrous acid and nitrogen oxides at midday under typical marine boundary layer conditions. Given that oceans account for more than 70 per cent of Earth's surface, we propose that particulate nitrate photolysis could be a substantial tropospheric nitrogen oxide source. Recycling of nitrogen oxides in remote oceanic regions with minimal direct nitrogen oxide emissions could increase the formation of tropospheric oxidants and secondary atmospheric aerosols on a global scale.

  19. Rapid thermal cycling of metal-supported solid oxide fuel cellmembranes

    Energy Technology Data Exchange (ETDEWEB)

    Matus, Yuriy B.; De Jonghe, Lutgard C.; Jacobson, Craig P.; Visco, Steven J.

    2004-01-02

    Solid oxide fuel cell (SOFC) membranes were developed in which zirconia-based electrolyte thin films were supported by a composite metal/ceramic electrode, and were subjected to rapid thermal cycling between 200 and 800 C. The effects of this cycling on membrane performance were evaluated. The membranes, not yet optimized for performance, showed a peak power density of 350mW/cm2at 900 C in laboratory-sized SOFCs that was not affected by the thermal cycling. This resistance to cycling degradation is attributed to the close matching of thermal expansion coefficient of the cermet support electrode with that of the zirconia electrolyte.

  20. Bordering on bipolar: the overlap between borderline personality and bipolarity.

    Science.gov (United States)

    Coulston, Carissa M; Tanious, Michelle; Mulder, Roger T; Porter, Richard J; Malhi, Gin S

    2012-06-01

    There is much debate over whether borderline personality disorder (BPD) belongs to the bipolar spectrum. The diagnosis of bipolar disorder (BD) in BPD patients, and conversely, BPD in BD patients is common, indicating prevalent co-morbidity, as well as potential misdiagnosis in either group. BD and BPD are often indistinguishable given the core characteristics of emotional dysregulation and impulsivity that feature in both. However, it may be argued that the manifestation of these characteristics in the two groups is different, and that the symptoms are driven by distinct aetiological factors. The primary objective of this paper was to examine where potential areas of discrimination lie between BD and BPD. A literature search was conducted using MEDLINE and PubMed databases to identify studies that have researched BD and BPD across the recognised domains of emotional dysregulation, impulsivity, childhood trauma, and their putative neurobiological substrates. Research comparing BD and BPD patients on self-report measures is limited, and no studies have examined their neurobiological underpinnings in the same design. One possible differentiating variable is childhood trauma which shapes the circumstances in which emotional dysregulation and impulsivity are triggered, the types of behaviours exhibited, and the frequency and duration of mood states. There is growing evidence that childhood trauma not only predisposes individuals to both disorders, but also modulates the clinical expression and course of bipolar illness, particularly rapid cycling BD, a form of bipolarity that resembles the clinical profile of BPD, yet presents quite distinctly from other BD subtypes. This paper provides an overview of BD and BPD with respect to emotional dysregulation, impulsivity, childhood factors, and neurobiological substrates. Based on findings predominantly within the independent areas of BD and BPD, it tentatively provides an integrated behavioural, aetiological and

  1. The oncogene c-Myc coordinates regulation of metabolic networks to enable rapid cell cycle entry.

    Science.gov (United States)

    Morrish, Fionnuala; Neretti, Nicola; Sedivy, John M; Hockenbery, David M

    2008-04-15

    The c-myc proto-oncogene is rapidly activated by serum and regulates genes involved in metabolism and cell cycle progression. This gene is thereby uniquely poised to coordinate both the metabolic and cell cycle regulatory events required for cell cycle entry. However, this function of Myc has not been evaluated. Using a rat fibroblast model of isogenic cell lines, myc(-/-), myc(+/-), myc(+/+) and myc(-/-) cells with an inducible c-myc transgene (mycER), we show that the Myc protein programs cells to utilize both oxidative phosphorylation and glycolysis to drive cell cycle progression. We demonstrate this coordinate regulation of metabolic networks is essential, as specific inhibitors of these pathways block Myc-induced proliferation. Metabolic events temporally correlated with cell cycle entry include increased oxygen consumption, mitochondrial function, pyruvate and lactate production, and ATP generation. Treatment of normal cells with inhibitors of oxidative phosphorylation recapitulates the myc(-/-) phenotype, resulting in impaired cell cycle entry and reduced metabolism. Combined with a kinetic expression profiling analysis of genes linked to mitochondrial function, our study indicates that Myc's ability to coordinately regulate the mitochondrial metabolic network transcriptome is required for rapid cell cycle entry. This function of Myc may underlie the pervasive presence of Myc in many human cancers.

  2. Demonstrated Ways to Use Rapid Cycling "Brassica Rapa" in Ecology Instruction and Research

    Science.gov (United States)

    Kelly, Martin G.

    2004-01-01

    The National Science Foundation has a long supported the use of "Wisconsin Fast Plants" (rapid cycling "B. rapa") in the teaching of Biology (K-12). I believe that the opportunity is at hand for biologists to significantly extend past efforts made by our colleagues at the K-12 level to higher education. Biology faculty can realize the many…

  3. Lamotrigine (Lamictal IR) for the treatment of bipolar disorder.

    Science.gov (United States)

    Bowden, Charles L; Singh, Vivek

    2012-12-01

    Over the past decade the use of lamotrigine in bipolar disorder has increased. However, the evidence base suggests a more limited role for lamotrigine as part of an overall treatment regimen in bipolar disorder. We reviewed publications of randomized clinical trials of lamotrigine, emphasizing studies in bipolar disorder. The low burden of adverse effects with lamotrigine has been confirmed in these studies. Its lack of benefit in acute mania is established. Despite modest benefits for a subset of depressive episodes in bipolar disorder, it was not superior to placebo in well-designed studies. As monotherapy, in randomized, blinded trials in rapid cycling bipolar disorder it was not superior to placebo. Its role in maintenance treatment is relatively well established as one component of combination therapy, with evidence for benefits when combined with lithium or valproate. Combination regimens including lamotrigine appear to be superior to monotherapy. Monotherapy utilization of lamotrigine for maintenance treatment is not supported by these studies. Lamotrigine has benefits in bipolar disorder management principally as a component of combination treatment which includes a mood stabilizer. The utility of lamotrigine in acute bipolar depression and major depressive disorder is modest.

  4. [Antipsychotics in bipolar disorders].

    Science.gov (United States)

    Vacheron-Trystram, M-N; Braitman, A; Cheref, S; Auffray, L

    2004-01-01

    may worsen depressive symptoms when used for a long term maintenance therapy. Additionally, mixed mania, rapid cycling type patients and bipolar disorder associated with substance abuse do not respond well to lithium therapy. In addition to the lithium therapy or in place of a lithium therapy, one can report the frequent use of antipsychotic agents in respect of patients with bipolar disorder during both the acute and maintenance phases of treatment. Antipsychotic agents have been used for almost forty years and may be used in combination with a lithium therapy. Conventional antipsychotics are effective but they may induce late dyskinesia, weight gain, sedation, sexual dysfunction and depression. These adverse side effects often lead to non compliance in particular in circumstances where antipsychotic agents are combined with a lithium therapy. A number of alternative somatic treatment approaches have been reported for patients who do not respond well or who are intolerant to lithium therapy. As such, valproate has received regulatory approval for the acute treatment of mania and carbamazepine has been indicated for this condition in a number of countries. Divalproex (Depakote) has recently obtained the authorization to market in France and may be prescribed for manic states or hypomanic states that do not tolerate lithium therapy or for which lithium therapy is contraindicated. A number of other anticonvulsants (lamotrigine, gabapentin and topiramate) are currently being tested. Because of the side effects of the conventional antipsychotic agents, atypical antipsychotic agents are currently on trial and appear to be of interest in the treatment of bipolar disorders. Currently, a number of prospective studies are available with clozapine, risperidone and olanzapine in the treatment of bipolar disorder. Most are short-term studies. Recent randomised, double-blind, placebo-controlled studies have shown clozapine, risperidone and olanzapine to be effective with antimanic

  5. Degradation of Teflon(trademark) FEP Following Charged Particle Radiation and Rapid Thermal Cycling

    Science.gov (United States)

    Townsend, Jacqueline; Powers, Charles; Viens, Michael; Ayres-Treusdell, Mary; Munoz, Bruno

    1999-01-01

    During the Second Servicing Mission (SM2) of the Hubble Space Telescope (HST) severe degradation was observed on the outer layer of the thermal control blankets. Astronaut observations and photographs revealed large cracks in the metallized Teflon(trademark) FEP (fluorinated ethylene propylene), the outer layer of the multi-layer insulation (MLI), in many locations around the telescope. In an effort to understand what elements of the space environment might cause such damage, pristine Teflon(trademark) FEP was tested for durability to radiation and thermal cycling. Specimens were subjected to electron and proton fluences comparable to those experienced by HST and were subsequently thermal cycled in a custom-built rapid thermal cycle chamber. Tensile tests of the specimens showed that radiation followed by thermal cycling significantly reduced the ultimate strength and elongation of Teflon(trademark) FEP.

  6. Degradation of Teflon(tm) FEP Following Charged Particle Radiation and Rapid Thermal Cycling

    Science.gov (United States)

    Townsend, Jacqueline; Powers, Charles; Viens, Michael; Ayres-Treusdell, Mary; Munoz, Bruno

    1998-01-01

    During the Second Servicing Mission (SM2) of the Hubble Space Telescope (HST) severe degradation was observed on the outer layer of the thermal control blankets. Astronaut observations and photographs revealed large cracks in the metallized Teflon(R) FEP (fluorinated ethylene propylene), the outer layer of the multi-layer insulation (MLI), in many locations around the telescope. In an effort to understand what elements of the space environment might cause such damage, pristine Teflon(R) FEP was tested for durability to radiation and thermal cycling. Specimens were subjected to electron and proton fluences comparable to those experienced by HST and were subsequently thermal cycled in a custom-built rapid thermal cycle chamber. Tensile tests of the specimens showed that radiation followed by thermal cycling significantly reduced the ultimate strength and elongation of Teflon(R) FEP.

  7. SUN-LIKE MAGNETIC CYCLES IN THE RAPIDLY ROTATING YOUNG SOLAR ANALOG HD 30495

    Energy Technology Data Exchange (ETDEWEB)

    Egeland, Ricky [High Altitude Observatory, National Center for Atmospheric Research, P.O. Box 3000, Boulder, CO 80307-3000 (United States); Metcalfe, Travis S. [Space Science Institute, 4750 Walnut St. Suite 205, Boulder, CO 80301 (United States); Hall, Jeffrey C. [Lowell Observatory, 1400 West Mars Hill Road, Flagstaff, AZ 86001 (United States); Henry, Gregory W., E-mail: egeland@ucar.edu [Center of Excellence in Information Systems, Tennessee State University, 3500 John A. Merritt Blvd., Box 9501, Nashville, TN 37209 (United States)

    2015-10-10

    A growing body of evidence suggests that multiple dynamo mechanisms can drive magnetic variability on different timescales, not only in the Sun but also in other stars. Many solar activity proxies exhibit a quasi-biennial (∼2 year) variation, which is superimposed upon the dominant 11 year cycle. A well-characterized stellar sample suggests at least two different relationships between rotation period and cycle period, with some stars exhibiting long and short cycles simultaneously. Within this sample, the solar cycle periods are typical of a more rapidly rotating star, implying that the Sun might be in a transitional state or that it has an unusual evolutionary history. In this work, we present new and archival observations of dual magnetic cycles in the young solar analog HD 30495, a ∼1 Gyr old G1.5 V star with a rotation period near 11 days. This star falls squarely on the relationships established by the broader stellar sample, with short-period variations at ∼1.7 years and a long cycle of ∼12 years. We measure three individual long-period cycles and find durations ranging from 9.6 to 15.5 years. We find the short-term variability to be intermittent, but present throughout the majority of the time series, though its occurrence and amplitude are uncorrelated with the longer cycle. These essentially solar-like variations occur in a Sun-like star with more rapid rotation, though surface differential rotation measurements leave open the possibility of a solar equivalence.

  8. Clinical and dimensional characteristics of euthymic bipolar patients with or without suicidal behavior.

    Science.gov (United States)

    Parmentier, C; Etain, B; Yon, L; Misson, H; Mathieu, F; Lajnef, M; Cochet, B; Raust, A; Kahn, J P; Wajsbrot-Elgrabli, O; Cohen, R; Henry, C; Leboyer, M; Bellivier, F

    2012-11-01

    The clinical and dimensional features associated with suicidal behaviour in bipolar patients during euthymic states are not well characterised. In a sample of 652 euthymic bipolar patients, we assessed clinical features with the Diagnostic Interview for Genetics Studies (DIGS) and dimensional characteristics with questionnaires measuring impulsivity/hostility and affective lability/intensity. Bipolar patients with and without suicidal behaviour were compared for these clinical and dimensional variables. Of the 652 subjects, 42.9% had experienced at least one suicide attempt. Lifetime history of suicidal behaviour was associated with being a woman, a history of head injury, tobacco misuse and indicators of severity of bipolar disorder including early age at onset, high number of depressive episodes, positive history of rapid cycling, alcohol misuse and social phobia. Indirect hostility and irritability were dimensional characteristics associated with suicidal behaviour in bipolar patients, whereas impulsivity and affective lability/intensity were not associated with suicidal behaviour. This study had a retrospective design with no replication sample. Bipolar patients with earlier onset, mood instability (large number of depressive episodes, rapid cycling) and/or particular addictive and anxiety comorbid disorders might be at high risk of suicidal behaviour. In addition, hostility dimensions (indirect hostility and irritability), may be trait components associated with suicidal behaviour in euthymic bipolar patients. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  9. A new concept of maternity blues : Is there a subgroup of women with rapid cycling mood symptoms?

    NARCIS (Netherlands)

    Pop, V.J.M.; Truijens, S.E.M.; Spek, V.R.M.; Wijnen, H. A.; van Son, M.J.M.; Bergink, V.

    2015-01-01

    Background Rapid cycling mood symptoms during the first postpartum week are an important aspect of maternity blues. The aim of this study is to identify women with these rapid cycling mood symptoms in the general population and to investigate possible risk factors of these symptoms. Methods The

  10. Rapid imaging of free radicals in vivo using field cycled PEDRI.

    Science.gov (United States)

    Puwanich, P; Lurie, D J; Foster, M A

    1999-12-01

    Imaging of free radicals in vivo using an interleaved field-cycled proton-electron double-resonance imaging (FC-PEDRI) pulse sequence has recently been investigated. In this work, in order to reduce the EPR (electron paramagnetic resonance) irradiation power required and the imaging time, a centric reordered snapshot FC-PEDRI pulse sequence has been implemented. This is based on the FLASH pulse sequence with a very short repetition time and the use of centric reordering of the phase-encoding gradient, allowing the most significant free induction decay (FID) signals to be collected before the signal enhancement decays significantly. A new technique of signal phaseshift correction was required to eliminate ghost artefacts caused by the instability of the main magnetic field after field cycling. An FID amplitude correction scheme has also been implemented to reduce edge enhancement artefacts caused by the rapid change of magnetization population before reaching the steady state. Using the rapid pulse sequence, the time required for acquisition of a 64 x 64 pixel FC-PEDRI image was reduced to 6 s per image compared with about 2.5 min with the conventional pulse sequence. The EPR irradiation power applied to the sample was reduced by a factor of approximately 64. Although the resulting images obtained by the rapid pulse sequence have a lower signal to noise than those obtained by a normal interleaved FC-PEDRI pulse sequence, the results show that rapid imaging of free radicals in vivo using snapshot FC-PEDRI is possible.

  11. Bipolar Disorder

    Science.gov (United States)

    Bipolar disorder is a serious mental illness. People who have it go through unusual mood changes. They go ... The down feeling is depression. The causes of bipolar disorder aren't always clear. It runs in families. ...

  12. The Rapid Transit System That Achieves Higher Performance with Lower Life-Cycle Costs

    Science.gov (United States)

    Sone, Satoru; Takagi, Ryo

    In the age of traction system made of inverter and ac traction motors, distributed traction system with pure electric brake of regenerative mode has been recognised very advantageous. This paper proposes a new system as the lowest life-cycle cost system for high performance rapid transit, a new architecture and optimum parameters of power feeding system, and a new running method of trains. In Japan, these components of this proposal, i.e. pure electric brake and various countermeasures of reducing loss of regeneration have been already popular but not as yet the new running method for better utilisation of the equipment and for lower life-cycle cost. One example of what are proposed in this paper will be made as Tsukuba Express, which is under construction as the most modern commuter railway in Greater Tokyo area.

  13. Study of a Rapid Cycling Synchrotron to replace the CERN PS Booster

    CERN Document Server

    Hanke, K; Angoletta, M E; Balhan, B; Bartmann, W; Benedikt, M; Borburgh, J; Bozzini, D; Carli, C; Dahlen, P; Dobers, T; Fitterer, M; Garoby, R; Gilardoni, S; Goddard, B; Hansen, J; Hermanns, T; Lopez-Hernandez, L A; Hourican, M; Jensen, S; Kosmicki, A; Meddahi, M; Mikulec, B; Newborough, A; Nonis, M; Olek, S; Paoluzzi, M; Pittet, S; Puccio, B; Raginel, V; Ruehl, I; Schönauer, H; Sermeus, L; Steerenberg, R; Tan, J; Tückmantel, J; Vretenar, M; Widorski, M

    2011-01-01

    CERN’s proton injector chain is undergoing a massive consolidation and upgrade program in order to deliver beams meeting the needs of the LHC Luminosity Upgrade. As an alternative to the upgrade of the existing Proton Synchrotron Booster (PSB), the construction of a Rapid Cycling Synchrotron (RCS) has been studied. This machine would replace the PSB and deliver beams to the LHC as well as to CERN’s rich fixed-target physics program. This paper summarizes the outcome of the feasibility study along with a tentative RCS design.

  14. A new concept of maternity blues: Is there a subgroup of women with rapid cycling mood symptoms?

    Science.gov (United States)

    Pop, Victor J M; Truijens, Sophie E M; Spek, Viola; Wijnen, Hennie A; van Son, Maarten J M; Bergink, Veerle

    2015-05-15

    Rapid cycling mood symptoms during the first postpartum week are an important aspect of maternity blues. The aim of this study is to identify women with these rapid cycling mood symptoms in the general population and to investigate possible risk factors of these symptoms. The Maternity Blues Scale (MBS) was validated in The Netherlands in 949 women at one week postpartum. Personal and family history of mood disorders and obstetric demographics were collected and the Edinburgh Postnatal Depression Scale (EPDS) was completed. A 16-item three-factor MBS solution was found: depression, negative and positive affect. The latter two were used to define a rapid cycling mood symptoms group. Using the 75th percentile cut-off, 20 (2%) women reported high negative/high positive affect (rapid cycling mood group) and 65 (7%) women were depressed (EPDS≥11). A previous episode of depression, major life events and instrumental delivery were independently related to depression (OR 3.5, 2.5 and 2.3, respectively) while only a history of depression in first-degree relatives was independently related to rapid cycling mood (OR 3.4, 95% CI 1.2-9.8). Limitations First, no syndromal diagnoses were obtained for depression and rapid cycling mood disorder. Second, history of depression was self-reported (not based on structural psychiatric interviews). Third, our study was not designed to study the longitudinal follow-up of women with rapid cycling mood symptoms. Conclusion the 16-item MBS could be useful in screening programs in detecting postpartum women at risk for (severe) mood disorders. Postpartum women with 'rapid cycling mood symptoms' can be identified with a possible more familiar form of mood disorder. Copyright © 2015 Elsevier B.V. All rights reserved.

  15. Rapid imaging of free radicals in vivo using hybrid FISP field-cycled PEDRI

    Science.gov (United States)

    Youngdee, Wiwat; Lurie, David J.; Foster, Margaret A.

    2002-04-01

    A new pulse sequence for rapid imaging of free radicals is presented which combines snapshot imaging methods and conventional field-cycled proton electron double resonance imaging (FC-PEDRI). The new sequence allows the number of EPR irradiation periods to be optimized to obtain an acceptable SNR and spatial resolution of free radical distribution in the final image while reducing the RF power deposition and increasing the temporal resolution. Centric reordered phase encoding has been employed to counter the problem of rapid decay of the Overhauser-enhanced signal. A phase-correction scheme has also been used to correct problems arising from instability of the magnetic field following field-cycling. In vivo experiments were carried out using triaryl methyl free radical contrast agent, injected at a dose of 0.214 mmol kg-1 body weight in anaesthetized adult male Sprague-Dawley rats. Transaxial images through the abdomen were collected using 1, 2, 4 and 8 EPR irradiation periods. Using 4 EPR irradiation periods it was possible to generate free radical distributions of acceptable SNR and resolution. The EPR power deposition is reduced by a factor of 16 and the acquisition time is reduced by a factor of 4 compared to an acquisition using the conventional FC-PEDRI pulse sequence.

  16. Mining Available Data from the United States Environmental Protection Agency to Support Rapid Life Cycle Inventory Modeling of Chemical Manufacturing

    Science.gov (United States)

    Demands for quick and accurate life cycle assessments create a need for methods to rapidly generate reliable life cycle inventories (LCI). Data mining is a suitable tool for this purpose, especially given the large amount of available governmental data. These data are typically a...

  17. Transiently increased glutamate cycling in rat PFC is associated with rapid onset of antidepressant-like effects

    OpenAIRE

    Chowdhury, Golam M.I.; Zhang, Jie; Thomas, Monique; Banasr, Mounira; Ma, Xiaoxian; Pittman, Brian; Bristow, Linda; Schaeffer, Eric; Duman, Ronald; Rothman, Douglas; Behar, Kevin; Sanacora, Gerard

    2016-01-01

    Several drugs have recently been reported to induce rapid antidepressant effects in clinical trials and rodent models. Although the cellular mechanisms involved remain unclear, reports suggest that increased glutamate transmission contributes to these effects. Here, we demonstrate that the antidepressant-like efficacy of three unique drugs, with reported rapid onset antidepressant properties, is coupled with a rapid transient rise in glutamate cycling in medial prefronal cortex (mPFC) of awak...

  18. Realizing the potential of rapid-cycling Brassica as a model system for use in plant biology research

    Science.gov (United States)

    Musgrave, M. E.

    2000-01-01

    Rapid-cycling Brassica populations were initially developed as a model for probing the genetic basis of plant disease. Paul Williams and co-workers selected accessions of the six main species for short time to flower and rapid seed maturation. Over multiple generations of breeding and selection, rapid-cycling populations of each of the six species were developed. Because of their close relationship with economically important Brassica species, rapid-cycling Brassica populations, especially those of B. rapa (RCBr) and B. oleracea, have seen wide application in plant and crop physiology investigations. Adding to the popularity of these small, short-lived plants for research applications is their extensive use in K-12 education and outreach.

  19. Abnormal Facial Emotion Recognition in Depression: Serial Testing in an Ultra-Rapid-Cycling Patient.

    Science.gov (United States)

    George, Mark S.; Huggins, Teresa; McDermut, Wilson; Parekh, Priti I.; Rubinow, David; Post, Robert M.

    1998-01-01

    Mood disorder subjects have a selective deficit in recognizing human facial emotion. Whether the facial emotion recognition errors persist during normal mood states (i.e., are state vs. trait dependent) was studied in one male bipolar II patient. Results of five sessions are presented and discussed. (Author/EMK)

  20. Mode change of millennial CO2 variability during the last glacial cycle associated with a bipolar marine carbon seesaw.

    Science.gov (United States)

    Bereiter, Bernhard; Lüthi, Dieter; Siegrist, Michael; Schüpbach, Simon; Stocker, Thomas F; Fischer, Hubertus

    2012-06-19

    Important elements of natural climate variations during the last ice age are abrupt temperature increases over Greenland and related warming and cooling periods over Antarctica. Records from Antarctic ice cores have shown that the global carbon cycle also plays a role in these changes. The available data shows that atmospheric CO(2) follows closely temperatures reconstructed from Antarctic ice cores during these variations. Here, we present new high-resolution CO(2) data from Antarctic ice cores, which cover the period between 115,000 and 38,000 y before present. Our measurements show that also smaller Antarctic warming events have an imprint in CO(2) concentrations. Moreover, they indicate that during Marine Isotope Stage (MIS) 5, the peak of millennial CO(2) variations lags the onset of Dansgaard/Oeschger warmings by 250 ± 190 y. During MIS 3, this lag increases significantly to 870 ± 90 y. Considerations of the ocean circulation suggest that the millennial variability associated with the Atlantic Meridional Overturning Circulation (AMOC) undergoes a mode change from MIS 5 to MIS 4 and 3. Ocean carbon inventory estimates imply that during MIS 3 additional carbon is derived from an extended mass of carbon-enriched Antarctic Bottom Water. The absence of such a carbon-enriched water mass in the North Atlantic during MIS 5 can explain the smaller amount of carbon released to the atmosphere after the Antarctic temperature maximum and, hence, the shorter lag. Our new data provides further constraints for transient coupled carbon cycle-climate simulations during the entire last glacial cycle.

  1. Parasitic slow extraction of extremely weak beam from a high-intensity proton rapid cycling synchrotron

    Energy Technology Data Exchange (ETDEWEB)

    Zou, Ye [University of Science and Technology of China, Hefei, Anhui 230029 (China); Institute of High Energy Physics, CAS, Yuquan Road 19B, Beijing 100049 (China); Tang, Jingyu, E-mail: tangjy@ihep.ac.cn [University of Science and Technology of China, Hefei, Anhui 230029 (China); Institute of High Energy Physics, CAS, Yuquan Road 19B, Beijing 100049 (China); Yang, Zheng; Jing, Hantao [Institute of High Energy Physics, CAS, Yuquan Road 19B, Beijing 100049 (China)

    2014-02-11

    This paper proposes a novel method to extract extremely weak beam from a high-intensity proton rapid cycling synchrotron (RCS) in the parasitic mode, while maintaining the normal fast extraction. The usual slow extraction method from a synchrotron by employing third-order resonance cannot be applied in a high-intensity RCS due to a very short flat-top at the extraction energy and the strict control on beam loss. The proposed parasitic slow extraction method moves the beam to scrape a scattering foil prior to the fast beam extraction by employing either a local orbit bump or momentum deviation or their combination, so that the halo part of the beam will be scattered. A part of the scattered particles will be extracted from the RCS and guided to the experimental area. The slow extraction process can last about a few milliseconds before the beam is extracted by the fast extraction system. The method has been applied to the RCS of China Spallation Neutron Source. With 1.6 GeV in the extraction energy, 62.5 μA in the average current and 25 Hz in the repetition rate for the RCS, the proton intensity by the slow extraction method can be up to 2×10{sup 4} protons per cycle or 5×10{sup 5} protons per second. The extracted beam has also a good time structure of approximately uniform in a spill which is required for many applications such as detector tests. Detailed studies including the scattering effect in the foil, the local orbit bump by the bump magnets and dispersive orbit bump by modifying the RF pattern, the multi-particle simulations by ORBIT and TURTLE codes, and some technical features for the extraction magnets are presented.

  2. Rapid response of the steatosis-sensing hepatokine LECT2 during diet-induced weight cycling in mice.

    Science.gov (United States)

    Chikamoto, Keita; Misu, Hirofumi; Takayama, Hiroaki; Kikuchi, Akihiro; Ishii, Kiyo-Aki; Lan, Fei; Takata, Noboru; Tajima-Shirasaki, Natsumi; Takeshita, Yumie; Tsugane, Hirohiko; Kaneko, Shuichi; Matsugo, Seiichi; Takamura, Toshinari

    2016-09-23

    Dieting often leads to body weight cycling involving repeated weight loss and regain. However, little information is available regarding rapid-response serum markers of overnutrition that predict body weight alterations during weight cycling. Here, we report the rapid response of serum leukocyte cell-derived chemotaxin 2 (LECT2), a hepatokine that induces insulin resistance in skeletal muscle, during diet-induced weight cycling in mice. A switch from a high-fat diet (HFD) to a regular diet (RD) in obese mice gradually decreased body weight but rapidly decreased serum LECT2 levels within 10 days. In contrast, a switch from a RD to a HFD rapidly elevated serum LECT2 levels. Serum LECT2 levels showed a positive correlation with liver triglyceride contents but not with adipose tissue weight. This study demonstrates the rapid response of LECT2 preceding body weight alterations during weight cycling in mice and suggests that measurement of serum LECT2 may be clinically useful in the management of obesity. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  3. Transtorno bipolar do humor e gênero Bipolar affective disorder and gender

    Directory of Open Access Journals (Sweden)

    Rodrigo da Silva Dias

    2006-01-01

    Full Text Available Embora o transtorno bipolar (TB ocorra quase igualmente em ambos os sexos, a fenomenologia e o curso da doença diferem no homem e na mulher. No entanto, há evidências de que mulheres bipolares, mais que os homens, apresentariam início mais tardio (em especial na quinta década de vida, ciclagem rápida, mais episódios depressivos, mais mania disfórica que eufórica, estados mistos e evolução do tipo bipolar II, ainda que os achados nem sempre sejam consistentes. Embora o risco de comorbidades no TB inclua, para ambos os gêneros, abuso de álcool e drogas, homens bipolares teriam maior probabilidade de ser alcoolistas, não procurar tratamento e de se suicidar. Hipóteses sugeridas para explicar tais diferenças variam daquelas centradas em aspectos culturais ou psicológicos para as que focalizam os sistemas hormonais, como os esteróides gonadais ou o eixo tireoidiano, e até mesmo a anatomia cerebral. A influência do ciclo reprodutivo (ciclo menstrual, gravidez e menopausa sobre as opções terapêuticas no tratamento do TB é apresentada na última parte desta revisão.Although the bipolar disorder (BD occurs almost with the same frequency in both genders, the phenomenology and the outcome of the illness differ between them. Nevertheless, there is evidence that women with BD show, more than men, delayed beginning, especially in their fifth decade, more rapid cycling outcome, more depressive episodes, more dysphoric mania, more mixed states and more BD type II. Even so, the findings are not always consistent. Although the risk of comorbidities in BD includes, for both the sorts, excessive alcoholic consumption and drugs, bipolar men would have greater probability of being alcohol dependent, of not seeking treatment and of committing suicide. Suggested hypotheses to explain such differences vary from those centered in cultural or psychological aspects to those that focus on the steroids hormones, and other hormones such as cortisol

  4. Types of Bipolar Disorder

    Science.gov (United States)

    ... Treatments and Therapies Join a Study Learn More Bipolar Disorder Overview Bipolar disorder, also known as manic-depressive ... known as major depressive disorder with mixed features. Bipolar Disorder and Other Illnesses Some bipolar disorder symptoms are ...

  5. Bipolar disorder

    OpenAIRE

    Goodwin, Frederick K.; Ghaemi, S. Nassir

    1999-01-01

    Bipolar disorder's unique combination of three characteristics - clear genetic diathesis, distinctive clinical features, early availability of an effective treatment (lithium) - explains its special place in the history of psychiatry and its contribution to the current explosive growth of neuroscience. This article looks at the state of the art in bipolar disorder from the vantage point of: (i) genetics (possible linkages on chromosomes 18 and 21q, polygenic hypothesis, research into genetic ...

  6. Combined momentum collimation studies in a high-intensity rapid cycling proton synchrotron

    Directory of Open Access Journals (Sweden)

    Jing-Yu Tang

    2011-05-01

    Full Text Available Momentum collimation in a high-intensity rapid cycling synchrotron (RCS is a very important issue. Based on the two-stage collimation principle, a combined momentum collimation method is proposed and studied in detail here. The method makes use of the combination of secondary collimators in both the longitudinal and transverse planes. The primary collimator is placed at a high-dispersion location of an arc, and the longitudinal and transverse secondary collimators are in the same arc and in the adjacent downstream dispersion-free long straight section, respectively. The particles with positive momentum deviations will be scattered and degraded by a carbon scraper and then collected mainly by the transverse collimators, whereas the particles with negative momentum deviations will be scattered by a tantalum scraper and mainly collected by the longitudinal secondary collimators. This is to benefit from the different effects of protons passing through a high atomic number material and a low atomic number material, as the former produces relatively more scattering than the latter for the same energy loss. The studies also reveal that momentum collimation is strongly dependent on the transverse beam correlation that comes from the injection painting. The relevant requirements on the lattice design are also discussed, especially for compact rings. The multiparticle simulations using both TURTLE and ORBIT codes are presented to show the physical images of the collimation method, which was carried out with the input of the RCS of China Spallation Neutron Source.

  7. A Method to Teach Age-Specific Demography with Field Grown Rapid Cycling "Brassica rapa" (Wisconsin Fast Plants)

    Science.gov (United States)

    Kelly, Martin G.; Terrana, Sebastian

    2004-01-01

    In this paper, we demonstrate that rapid cycling "Brassica rapa" (Wisconsin Fast Plants) can be used in inquiry-based, student ecological fieldwork. We are the first to describe age-specific survival for field-grown Fast Plants and identify life history traits associated with individual survival. This experiment can be adapted by educators as a…

  8. Fast Plants for Finer Science--An Introduction to the Biology of Rapid-Cycling Brassica Campestris (rapa) L.

    Science.gov (United States)

    Tomkins, Stephen P.; Williams, Paul H.

    1990-01-01

    Rapid-cycling brassicas can be used in the classroom to teach concepts such as plant growth, tropisms, floral reproduction, pollination, embryonic development, and plant genetics. Directions on how to obtain them for classroom use and how they may be grown are included. Practical physiology and genetics exercises are listed. (KR)

  9. Thermally moderated hollow fiber sorbent modules in rapidly cycled pressure swing adsorption mode for hydrogen purification

    KAUST Repository

    Lively, Ryan P.

    2012-10-01

    We describe thermally moderated multi-layered pseudo-monolithic hollow fiber sorbents entities, which can be packed into compact modules to provide small-footprint, efficient H2 purification/CO2 removal systems for use in on-site steam methane reformer product gas separations. Dual-layer hollow fibers are created via dry-jet, wet-quench spinning with an inner "active" core of cellulose acetate (porous binder) and zeolite NaY (69 wt% zeolite NaY) and an external sheath layer of pure cellulose acetate. The co-spun sheath layer reduces the surface porosity of the fiber and was used as a smooth coating surface for a poly(vinyl-alcohol) post-treatment, which reduced the gas permeance through the fiber sorbent by at least 7 orders of magnitude, essentially creating an impermeable sheath layer. The interstitial volume between the individual fibers was filled with a thermally-moderating paraffin wax. CO2 breakthrough experiments on the hollow fiber sorbent modules with and without paraffin wax revealed that the "passively" cooled paraffin wax module had 12.5% longer breakthrough times than the "non-isothermal" module. The latent heat of fusion/melting of the wax offsets the released latent heat of sorption/desorption of the zeolites. One-hundred rapidly cycled pressure swing adsorption cycles were performed on the "passively" cooled hollow fiber sorbents using 25 vol% CO2/75 vol% He (H2 surrogate) at 60 °C and 113 psia, resulting in a product purity of 99.2% and a product recovery of 88.1% thus achieving process conditions and product quality comparable to conventional pellet processes. Isothermal and non-isothermal dynamic modeling of the hollow fiber sorbent module and a traditional packed bed using gPROMS® indicated that the fiber sorbents have sharper fronts (232% sharper) and longer adsorbate breakthrough times (66% longer), further confirming the applicability of the new fiber sorbent approach for H2 purification. © 2012, Hydrogen Energy Publications, LLC

  10. Family Functioning and the Course of Adolescent Bipolar Disorder

    Science.gov (United States)

    Sullivan, Aimee E.; Judd, Charles M.; Axelson, David A.; Miklowitz, David J.

    2012-01-01

    The symptoms of bipolar disorder affect and are affected by the functioning of family environments. Little is known, however, about the stability of family functioning among youth with bipolar disorder as they cycle in and out of mood episodes. This study examined family functioning and its relationship to symptoms of adolescent bipolar disorder,…

  11. Rapid Titration of Measles and Other Viruses: Optimization with Determination of Replication Cycle Length

    Science.gov (United States)

    Grigorov, Boyan; Rabilloud, Jessica; Lawrence, Philip; Gerlier, Denis

    2011-01-01

    Background Measles virus (MV) is a member of the Paramyxoviridae family and an important human pathogen causing strong immunosuppression in affected individuals and a considerable number of deaths worldwide. Currently, measles is a re-emerging disease in developed countries. MV is usually quantified in infectious units as determined by limiting dilution and counting of plaque forming unit either directly (PFU method) or indirectly from random distribution in microwells (TCID50 method). Both methods are time-consuming (up to several days), cumbersome and, in the case of the PFU assay, possibly operator dependent. Methods/Findings A rapid, optimized, accurate, and reliable technique for titration of measles virus was developed based on the detection of virus infected cells by flow cytometry, single round of infection and titer calculation according to the Poisson's law. The kinetics follow up of the number of infected cells after infection with serial dilutions of a virus allowed estimation of the duration of the replication cycle, and consequently, the optimal infection time. The assay was set up to quantify measles virus, vesicular stomatitis virus (VSV), and human immunodeficiency virus type 1 (HIV-1) using antibody labeling of viral glycoprotein, virus encoded fluorescent reporter protein and an inducible fluorescent-reporter cell line, respectively. Conclusion Overall, performing the assay takes only 24–30 hours for MV strains, 12 hours for VSV, and 52 hours for HIV-1. The step-by-step procedure we have set up can be, in principle, applicable to accurately quantify any virus including lentiviral vectors, provided that a virus encoded gene product can be detected by flow cytometry. PMID:21915289

  12. Bipolar disorder.

    Science.gov (United States)

    Goodwin, F K; Ghaemi, S N

    1999-06-01

    Bipolar disorder's unique combination of three characteristics - clear genetic diathesis, distinctive clinical features, early availability of an effective treatment (lithium) - explains its special place in the history of psychiatry and its contribution to the current explosive growth of neuroscience. This article looks at the state of the art in bipolar disorder from the vantage point of: (i) genetics (possible linkages on chromosomes 18 and 21q, polygenic hypothesis, research into genetic markers); (ii) diagnosis (new focus on the subjective aspects of bipolar disorder to offset the current trend of underdiagnosis due to overreliance on standardized interviews and rating scales); (iii) outcome (increase in treatment-resistant forms signaling a change in the natural history of bipolar disorder); (iv) pathophysiology (research into circadian biological rhythms and the kindling hypothesis to explain recurrence); (v) treatment (emergence of the anticonvulsants, suggested role of chronic antidepressant treatment in the development of treatment resistance); (vi) neurobiology (evaluation of regulatory function in relation to affective disturbances, role of postsynaptic second-messenger mechanisms, advances in functional neuroimaging); and (vii) psychosocial research (shedding overly dualistic theories of the past to understand the mind and brain as an entity, thus emphasizing the importance of balancing the psychopharmacological and psychotherapeutic approaches). Future progress in the understanding and treatment of bipolar disorder will rely on successful integration of the biological and psychosocial lines of investigation.

  13. Neutrality in bipolar structures

    DEFF Research Database (Denmark)

    Montero, Javier; Rodríguez, J. Tinguaro; Franco, Camilo

    2014-01-01

    In this paper, we want to stress that bipolar knowledge representation naturally allows a family of middle states which define as a consequence different kinds of bipolar structures. These bipolar structures are deeply related to the three types of bipolarity introduced by Dubois and Prade, but our...... approach offers a systematic explanation of how such bipolar structures appear and can be identified....

  14. The relationship between self-reported borderline personality features and prospective illness course in bipolar disorder.

    Science.gov (United States)

    Riemann, Georg; Weisscher, Nadine; Post, Robert M; Altshuler, Lori; McElroy, Susan; Frye, Marc A; Keck, Paul E; Leverich, Gabriele S; Suppes, Trisha; Grunze, Heinz; Nolen, Willem A; Kupka, Ralph W

    2017-09-25

    Although bipolar disorder (BD) and borderline personality disorder (BPD) share clinical characteristics and frequently co-occur, their interrelationship is controversial. Especially, the differentiation of rapid cycling BD and BPD can be troublesome. This study investigates the relationship between borderline personality features (BPF) and prospective illness course in patients with BD, and explores the effects of current mood state on self-reported BPF profiles. The study included 375 patients who participated in the former Stanley Foundation Bipolar Network. All patients met DSM-IV criteria for bipolar-I disorder (n = 294), bipolar-II disorder (n = 72) or bipolar disorder NOS (n = 9). BPF were assessed with the self-rated Personality Diagnostic Questionnaire. Illness course was based on 1-year clinician rated prospective daily mood ratings with the life chart methodology. Regression analyses were used to estimate the relationships among these variables. Although correlations were weak, results showed that having more BPF at baseline is associated with a higher episode frequency during subsequent 1-year follow-up. Of the nine BPF, affective instability, impulsivity, and self-mutilation/suicidality showed a relationship to full-duration as well as brief episode frequency. In contrast all other BPF were not related to episode frequency. Having more BPF was associated with an unfavorable illness course of BD. Affective instability, impulsivity, and self-mutilation/suicidality are associated with both rapid cycling BD and BPD. Still, many core features of BPD show no relationship to rapid cycling BD and can help in the differential diagnosis.

  15. Publication bias and the pharmaceutical industry: the case of lamotrigine in bipolar disorder.

    Science.gov (United States)

    Nassir Ghaemi, S; Shirzadi, Arshia A; Filkowski, Megan

    2008-01-01

    Publication bias, especially the lack of publication of negative treatment studies, is known to be a major problem in the medical literature. In particular, it appears that the pharmaceutical industry is not routinely making data from negative studies available through the published scientific literature. In this paper, we review the case of studies with lamotrigine in bipolar disorder, describing evidence of lack of efficacy in multiple mood states outside of the primary area of efficacy (prophylaxis of mood episodes). In particular, the drug has very limited, if any, efficacy in acute bipolar depression and rapid-cycling bipolar disorder, areas in which practicing clinicians, as well as some academic leaders, have supported its use. The negative unpublished data now made available on lamotrigine provide an important context for clinical practice and research, and also raise important scientific and public policy concerns about having access to studies showing inefficacy with psychotropic medications.

  16. A composite peripheral blood gene expression measure as a potential diagnostic biomarker in bipolar disorder

    DEFF Research Database (Denmark)

    Munkholm, Klaus; Peijs, L; Vinberg, M

    2015-01-01

    as a diagnostic and state biomarker in bipolar disorder. First, messenger RNA levels of 19 candidate genes were assessed in peripheral blood mononuclear cells of 37 rapid cycling bipolar disorder patients in different affective states (depression, mania and euthymia) during a 6-12-month period and in 40 age......Gene expression in peripheral blood has the potential to inform on pathophysiological mechanisms and has emerged as a viable avenue for the identification of biomarkers. Here, we aimed to identify gene expression candidate genes and to explore the potential for a composite gene expression measure......- and gender-matched healthy control subjects. Second, a composite gene expression measure was constructed in the first half study sample and independently validated in the second half of the sample. We found downregulation of POLG and OGG1 expression in bipolar disorder patients compared with healthy control...

  17. Elevated levels of urinary markers of oxidatively generated DNA and RNA damage in bipolar disorder

    DEFF Research Database (Denmark)

    Munkholm, Klaus; Poulsen, Henrik Enghusen; Kessing, Lars Vedel

    2015-01-01

    investigated oxidatively generated damage to DNA and RNA in patients with bipolar disorder and its relationship with the affective phase compared with healthy control subjects. METHODS: Urinary excretion of 8-oxo-7,8-dihydro-2'-deoxyguanosine (8-oxodG) and 8-oxo-7,8-dihydroguanosine (8-oxoGuo), markers...... of oxidatively generated DNA and RNA damage, respectively, was measured in 37 rapid cycling patients with bipolar disorder and in 40 age- and gender-matched healthy control subjects. Employing a longitudinal design, repeated measurements of both markers were evaluated in various affective phases in patients....... CONCLUSIONS: Our results indicate that bipolar disorder is associated with increased oxidatively generated damage to nucleosides. The findings could suggest a role for oxidatively generated damage to DNA and RNA as a molecular mechanism contributing to the increased risk of medical disorders, shortened life...

  18. Sex and estrous cycle-dependent rapid protein kinase signaling actions of estrogen in distal colonic cells.

    LENUS (Irish Health Repository)

    O'Mahony, Fiona

    2008-10-01

    Previous studies from our laboratory demonstrated that 17beta-estradiol (E2) rapidly inhibits Cl(-) secretion in rat and human distal colonic epithelium. The inhibition has been shown to occur via targeting of a basolateral K(+) channel identified as the KCNQ1 (KvLQT1) channel. E2 indirectly modulates the channel activity via a cascade of second messengers which are rapidly phosphorylated in response to E2. The anti-secretory mechanism may be the manner by which E2 induces fluid retention in the intestine during periods of high circulating plasma E2. Here we review the sex-dependent and estrous cycle regulation of this novel rapid response to E2. The inhibition of KCNQ1 channel activity and Cl(-) secretion will be of interest in the future in the investigation of the retentive effects of estrogen in female tissue and also in the study of secretory disorders and drugable targets of the intestine.

  19. Cayley Bipolar Fuzzy Graphs

    OpenAIRE

    Alshehri, Noura O.; Muhammad Akram

    2013-01-01

    We introduce the concept of Cayley bipolar fuzzy graphs and investigate some of their properties. We present some interesting properties of bipolar fuzzy graphs in terms of algebraic structures. We also discuss connectedness in Cayley bipolar fuzzy graphs.

  20. What is Bipolar Disorder?

    Science.gov (United States)

    ... affect friends and family? For More Information Share Bipolar Disorder Download PDF Download ePub Order a free hardcopy ... brochure will give you more information. What is bipolar disorder? Bipolar disorder is a serious brain illness. It ...

  1. Psychological therapy for anxiety in bipolar spectrum disorders: a systematic review.

    Science.gov (United States)

    Stratford, Hannah J; Cooper, Myra J; Di Simplicio, Martina; Blackwell, Simon E; Holmes, Emily A

    2015-02-01

    Comorbid anxiety is common in bipolar spectrum disorders [BPSD], and is associated with poor outcomes. Its clinical relevance is highlighted by the "anxious distress specifier" in the revised criteria for Bipolar Disorders in the Diagnostic and Statistical Manual 5th Edition [DSM-5]. This article reviews evidence for the effectiveness of psychological therapy for anxiety in adults with BPSD (bipolar I, II, not otherwise specified, cyclothymia, and rapid cycling disorders). A systematic search yielded 22 treatment studies that included an anxiety-related outcome measure. Cognitive behavioural therapy [CBT] for BPSD incorporating an anxiety component reduces anxiety symptoms in cyclothymia, "refractory" and rapid cycling BPSD, whereas standard bipolar treatments have only a modest effect on anxiety. Preliminary evidence is promising for CBT for post-traumatic stress disorder and generalised anxiety disorder in BPSD. Psychoeducation alone does not appear to reduce anxiety, and data for mindfulness-based cognitive therapy [MBCT] appear equivocal. CBT during euthymic phases has the greatest weight of evidence. Where reported, psychological therapy appears acceptable and safe, but more systematic collection and reporting of safety and acceptability information is needed. Development of psychological models and treatment protocols for anxiety in BPSD may help improve outcomes. Copyright © 2014. Published by Elsevier Ltd.

  2. Application of Bipolar Fuzzy Sets in Graph Structures

    Directory of Open Access Journals (Sweden)

    Muhammad Akram

    2016-01-01

    Full Text Available A graph structure is a useful tool in solving the combinatorial problems in different areas of computer science and computational intelligence systems. In this paper, we apply the concept of bipolar fuzzy sets to graph structures. We introduce certain notions, including bipolar fuzzy graph structure (BFGS, strong bipolar fuzzy graph structure, bipolar fuzzy Ni-cycle, bipolar fuzzy Ni-tree, bipolar fuzzy Ni-cut vertex, and bipolar fuzzy Ni-bridge, and illustrate these notions by several examples. We study ϕ-complement, self-complement, strong self-complement, and totally strong self-complement in bipolar fuzzy graph structures, and we investigate some of their interesting properties.

  3. Bipolar Treatment: Are Bipolar I and Bipolar II Treated Differently?

    Science.gov (United States)

    ... formerly called manic depression, generally involves medications and mental health counseling (psychotherapy) — whether you have bipolar I or bipolar ... medicine: Current evidence, safety issues, and clinical considerations. Journal of ... of Mental Health. http://www.nimh.nih.gov/health/publications/bipolar- ...

  4. Influence of Rapid Freeze-Thaw Cycling on the Mechanical Properties of Sustainable Strain-Hardening Cement Composite (2SHCC

    Directory of Open Access Journals (Sweden)

    Seok-Joon Jang

    2014-02-01

    Full Text Available This paper provides experimental results to investigate the mechanical properties of sustainable strain-hardening cement composite (2SHCC for infrastructures after freeze-thaw actions. To improve the sustainability of SHCC materials in this study, high energy-consumptive components—silica sand, cement, and polyvinyl alcohol (PVA fibers—in the conventional SHCC materials are partially replaced with recycled materials such as recycled sand, fly ash, and polyethylene terephthalate (PET fibers, respectively. To investigate the mechanical properties of green SHCC that contains recycled materials, the cement, PVA fiber and silica sand were replaced with 10% fly ash, 25% PET fiber, and 10% recycled aggregate based on preliminary experimental results for the development of 2SHCC material, respectively. The dynamic modulus of elasticity and weight for 2SHCC material were measured at every 30 cycles of freeze-thaw. The effects of freeze-thaw cycles on the mechanical properties of sustainable SHCC are evaluated by conducting compressive tests, four-point flexural tests, direct tensile tests and prism splitting tests after 90, 180, and 300 cycles of rapid freeze-thaw. Freeze-thaw testing was conducted according to ASTM C 666 Procedure A. Test results show that after 300 cycles of freezing and thawing actions, the dynamic modulus of elasticity and mass loss of damaged 2SHCC were similar to those of virgin 2SHCC, while the freeze-thaw cycles influence mechanical properties of the 2SHCC material except for compressive behavior.

  5. Transtorno bipolar

    OpenAIRE

    Alda Martin

    1999-01-01

    Os resultados de estudos de famílias sugerem que o transtorno bipolar tenha uma base genética. Essa hipótese foi reforçada em estudos de adoção e de gêmeos. A herança do transtorno bipolar é complexa, envolve vários genes, além de apresentar heterogeneidade e interação entre fatores genéticos e não-genéticos. Achados, que já foram replicados, já implicaram os cromossomos 4, 12, 18 e 21, entre outros, na busca por genes de suscetibilidade. Os resultados mais promissores foram obtidos através d...

  6. Transtorno bipolar

    Directory of Open Access Journals (Sweden)

    Alda Martin

    1999-01-01

    Full Text Available Os resultados de estudos de famílias sugerem que o transtorno bipolar tenha uma base genética. Essa hipótese foi reforçada em estudos de adoção e de gêmeos. A herança do transtorno bipolar é complexa, envolve vários genes, além de apresentar heterogeneidade e interação entre fatores genéticos e não-genéticos. Achados, que já foram replicados, já implicaram os cromossomos 4, 12, 18 e 21, entre outros, na busca por genes de suscetibilidade. Os resultados mais promissores foram obtidos através de estudos de ligação. Por outro lado, os estudos de associação geraram dados interessantes, mas ainda vagos. Os estudos de populações de pacientes homogêneos e a melhor definição do fenótipo deverão contribuir para avanços futuros. A identificação dos genes relacionados ao transtorno bipolar irá permitir o melhor entendimento e tratamento dessa doença.

  7. O transtorno bipolar na mulher Bipolar disorder in women

    Directory of Open Access Journals (Sweden)

    Alexandro de Borja Gonçalves Guerra

    2005-01-01

    Full Text Available Diferenças sexuais, descritas em vários transtornos psiquiátricos, também parecem estar presentes no transtorno afetivo bipolar (TAB. A prevalência do TAB tipo I se distribui igualmente entre mulheres e homens. Mulheres parecem estar sujeitas a um risco maior de ciclagem rápida e mania mista, condições que fariam do TAB um transtorno com curso mais prejudicial no sexo feminino. Uma diátese depressiva mais marcante, uso excessivo de antidepressivos e diferenças hormonais surgem como hipóteses para explicar essas diferenças fenomenológicas, apesar das quais, mulheres e homens parecem responder igualmente ao tratamento medicamentoso. A indicação de anticonvulsivantes como primeira escolha em mulheres é controversa, a não ser para o tratamento da mania mista e, talvez, da ciclagem rápida. O tratamento do TAB na gravidez deve levar em conta tanto os riscos de exposição aos medicamentos quanto à doença materna. A profilaxia do TAB no puerpério está fortemente indicada em decorrência do grande risco de recorrência da doença nesse período. Embora, de modo geral, as medicações psicotrópicas estejam contra-indicadas durante a amamentação, entre os estabilizadores do humor, a carbamazepina e o valproato são mais seguros do que o lítio. Mais estudos são necessários para a confirmação das diferenças de curso do TAB entre mulheres e homens e a investigação de possíveis diferenças na efetividade dos tratamentos.Gender differences, described in several psychiatric disorders, seem to be also present in bipolar disorder (BD. The prevalence of bipolar I disorder is equally distributed between women and men. Women seem to be at higher risk for rapid cycling and mixed mania, conditions that could make BD a disorder with a more severe course in the female sex. A marked depressive diathesis among women, greatest use of antidepressants and hormonal differences have been mentioned as hypotheses to explain these

  8. Beam commissioning of the 3-GeV rapid cycling synchrotron of the Japan Proton Accelerator Research Complex

    Directory of Open Access Journals (Sweden)

    H. Hotchi

    2009-04-01

    Full Text Available The 3-GeV rapid cycling synchrotron (RCS of the Japan Proton Accelerator Research Complex (J-PARC was commissioned in October 2007, and successfully accomplished 3 GeV acceleration on October 31. Six run cycles through February 2008 were dedicated to commissioning the RCS, for which the initial machine parameter tuning and various underlying beam studies were completed. Then since May 2008 the RCS beam has been delivered to the downstream facilities for their beam commissioning. In this paper we describe beam tuning and study results following our beam commissioning scenario and a beam performance and operational experience obtained in the first commissioning phase through June 2008.

  9. Mathematical models of bipolar disorder

    Science.gov (United States)

    Daugherty, Darryl; Roque-Urrea, Tairi; Urrea-Roque, John; Troyer, Jessica; Wirkus, Stephen; Porter, Mason A.

    2009-07-01

    We use limit cycle oscillators to model bipolar II disorder, which is characterized by alternating hypomanic and depressive episodes and afflicts about 1% of the United States adult population. We consider two non-linear oscillator models of a single bipolar patient. In both frameworks, we begin with an untreated individual and examine the mathematical effects and resulting biological consequences of treatment. We also briefly consider the dynamics of interacting bipolar II individuals using weakly-coupled, weakly-damped harmonic oscillators. We discuss how the proposed models can be used as a framework for refined models that incorporate additional biological data. We conclude with a discussion of possible generalizations of our work, as there are several biologically-motivated extensions that can be readily incorporated into the series of models presented here.

  10. Considerations in the pharmacotherapy of bipolar disorder during and after pregnancy.

    Science.gov (United States)

    Sharma, Verinder

    2011-11-01

    There are conflicting data on the course of bipolar disorder during pregnancy but childbirth is generally considered a time of high risk for the onset or exacerbation of mood and psychotic episodes in women with bipolar disorder. Despite the increasing use of psychotropic drugs in women with psychiatric disorders, there is a paucity of information in the pharmacological treatment of bipolar disorder during and after pregnancy. Optimal drug treatment requires an understanding of the illness course prior to, during, and after pregnancy; bipolar disorder type and dominant polarity, psychiatric comorbidity, physical health status, prior response to psychotropic drugs, effectiveness of medications in the acute and preventative treatment of mood episodes, side effect profile including teratogenicity, and finally family history of psychiatric illness. For women who discontinue psychotropic drugs abruptly upon finding out about the pregnancy, the withdrawal symptoms of medications should be distinguished from the symptoms of the disorder. Compatibility of drugs with breastfeeding is another important consideration. Antidepressants should be avoided as much as possible due to their association with manic switches, rapid cycling, and suicidality. An important aspect of pharmacotherapy in women with a personal or family history of bipolar I disorder or postpartum psychosis should be the management of insomnia that can either be an early symptom of, or a trigger for postpartum manic/mixed or psychotic episodes. Whereas polypharmacy may be unavoidable, every effort should be made to keep the overall number of medications and dosages to a minimum.

  11. Treatment of the depressive phase of bipolar affective disorder: a review.

    Science.gov (United States)

    Muneer, Ather

    2013-06-01

    Bipolar disorder is a chronic mood disorder which usually has its onset in adolescence and young adulthood. The disorder is typified by a remitting and relapsing course. While remissions are often partial in nature, relapses are frequent and manifested as manic, mixed, hypomanic and depressive episodes. Rapid cycling is a particularly disabling form of bipolar disorder, characterised by four or more episodes in a 12-month period. Bipolar disorder inevitably causes impairment in social and occupational functioning. Many patients experience severe hopelessness and suicidal ideation and the disorder is associated with one of the highest mortality rates of all psychiatric disorders. The treatment of bipolar depression is particularly challenging and numerous patients achieve incomplete benefit even with complex psychopharmacological strategies. In recent years, many new pharmacological options have become available for the treatment of bipolar depression and the field has seen significant progress. In order to achieve better outcome for the patients, it is mandatory that treating physicians have an up to date knowledge of recent advances in the management of this condition.

  12. Affect lability predicts occurrence of suicidal ideation in bipolar patients: a two-year prospective study.

    Science.gov (United States)

    Ducasse, D; Jaussent, I; Guillaume, S; Azorin, J M; Bellivier, F; Belzeaux, R; Bougerol, T; Etain, B; Gard, S; Henry, C; Kahn, J P; Leboyer, M; Loftus, J; Passerieux, C; Olié, E; Courtet, P

    2017-05-01

    The aim of our study was to investigate, in bipolar patients, whether affect lability was associated with suicidal ideation incidence during 2-year follow-up, and which subtype of affect lability was associated with suicidal ideation. A total of 319 euthymic or mildly depressed bipolar outpatients recruited in the French FondaMental Advanced Centres of Expertise for Bipolar Disorder were divided into two subgroups according to the occurrence of suicidal ideation during a 2-year follow-up. Affect lability was assessed by the French version of the Affect Lability Scale. Bipolar patients with high affect lability were more likely to report suicidal ideation during follow-up, even after adjustment for age, study level, rapid cycling, current depression level, anxiety disorder, and lifetime history SA (OR = 2.47; 95% CI [1.15-5.30], P = 0.01). The risk of suicidal ideation increased with the level of affect lability. More specifically, the propensity to switch from neutral to elation affect, from anxious to depressive affect (or inversely), and from neutral to anger affect predicted suicidal ideation. Reducing affective lability could become a new therapeutic target of suicidal prevention in bipolar disorder. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. Integrated neurobiology of bipolar disorder

    Directory of Open Access Journals (Sweden)

    Vladimir eMaletic

    2014-08-01

    Full Text Available From a neurobiological perspective there is no such thing as bipolar disorder. Rather, it is almost certainly the case that many somewhat similar, but subtly different, pathological conditions produce a disease state that we currently diagnose as bipolarity. This heterogeneity—reflected in the lack of synergy between our current diagnostic schema and our rapidly advancing scientific understanding of the condition—limits attempts to articulate an integrated perspective on bipolar disorder. However, despite these challenges, scientific findings in recent years are beginning to offer a provisional unified field theory of the disease. This theory sees bipolar disorder as a suite of related neurodevelopmental conditions with interconnected functional abnormalities that often appear early in life and worsen over time. In addition to accelerated loss of volume in brain areas known to be essential for mood regulation and cognitive function, consistent findings have emerged at a cellular level, providing evidence that bipolar disorder is reliably associated with dysregulation of glial-neuronal interactions. Among these glial elements are microglia—the brain’s primary immune elements, which appear to be overactive in the context of bipolarity. Multiple studies now indicate that inflammation is also increased in the periphery of the body in both the depressive and manic phases of the illness, with at least some return to normality in the euthymic state. These findings are consistent with changes in the HPA axis, which are known to drive inflammatory activation. In summary, the very fact that no single gene, pathway or brain abnormality is likely to ever account for the condition is itself an extremely important first step in better articulating an integrated perspective on both its ontological status and pathogenesis. Whether this perspective will translate into the discovery of innumerable more homogeneous forms of bipolarity is one of the great

  14. Rapid changes in the light/dark cycle disrupt memory of conditioned fear in mice.

    Directory of Open Access Journals (Sweden)

    Dawn H Loh

    Full Text Available BACKGROUND: Circadian rhythms govern many aspects of physiology and behavior including cognitive processes. Components of neural circuits involved in learning and memory, e.g., the amygdala and the hippocampus, exhibit circadian rhythms in gene expression and signaling pathways. The functional significance of these rhythms is still not understood. In the present study, we sought to determine the impact of transiently disrupting the circadian system by shifting the light/dark (LD cycle. Such "jet lag" treatments alter daily rhythms of gene expression that underlie circadian oscillations as well as disrupt the synchrony between the multiple oscillators found within the body. METHODOLOGY/PRINCIPAL FINDINGS: We subjected adult male C57Bl/6 mice to a contextual fear conditioning protocol either before or after acute phase shifts of the LD cycle. As part of this study, we examined the impact of phase advances and phase delays, and the effects of different magnitudes of phase shifts. Under all conditions tested, we found that recall of fear conditioned behavior was specifically affected by the jet lag. We found that phase shifts potentiated the stress-evoked corticosterone response without altering baseline levels of this hormone. The jet lag treatment did not result in overall sleep deprivation, but altered the temporal distribution of sleep. Finally, we found that prior experience of jet lag helps to compensate for the reduced recall due to acute phase shifts. CONCLUSIONS/SIGNIFICANCE: Acute changes to the LD cycle affect the recall of fear-conditioned behavior. This suggests that a synchronized circadian system may be broadly important for normal cognition and that the consolidation of memories may be particularly sensitive to disruptions of circadian timing.

  15. Sedimentary evidence for enhanced hydrological cycling in response to rapid carbon release during the early Toarcian oceanic anoxic event

    Science.gov (United States)

    Izumi, Kentaro; Kemp, David B.; Itamiya, Shoma; Inui, Mutsuko

    2018-01-01

    A pronounced excursion in the carbon-isotope composition of biospheric carbon and coeval seawater warming during the early Toarcian (∼183 Ma) has been linked to the large-scale transfer of 12C-enriched carbon to the oceans and atmosphere. A European bias in the distribution of available data means that the precise pattern, tempo and global expression of this carbon cycle perturbation, and the associated environmental responses, remain uncertain. Here, we present a new cm-scale terrestrial-dominated carbon-isotope record through an expanded lower Toarcian section from Japan that displays a negative excursion pattern similar to marine and terrestrial carbon-isotope records documented from Europe. These new data suggest that 12C-enriched carbon was added to the biosphere in at least one rapid, millennial-scale pulse. Sedimentological analysis indicates a close association between the carbon-isotope excursion and high-energy sediment transport and enhanced fluvial discharge. Together, these data support the hypothesis that a sudden strengthening of the global hydrological cycle occurred in direct and immediate response to rapid carbon release and atmospheric warming.

  16. Mechanical and Failure Criteria of Air-Entrained Concrete under Triaxial Compression Load after Rapid Freeze-Thaw Cycles

    Directory of Open Access Journals (Sweden)

    Feng-kun Cui

    2017-01-01

    Full Text Available The experiment study on the air-entrained concrete of 100 mm cubes under triaxial compression with different intermediate stress ratio α2=σ2D : σ3D was carried out using a hydraulic-servo testing system. The influence of rapid freeze-thaw cycles and intermediate stress ratio on the triaxial compressive strength σ3D was analyzed according to the experimental results, respectively. The experimental results of air-entrained concrete obtained from the study in this paper and the triaxial compression experimental results of plain concrete got through the same triaxial-testing-system were compared and analyzed. The conclusion was that the triaxial compressive strength is greater than the biaxial and uniaxial compressive strength after the same rapid freeze-thaw cycles, and the increased percentage of triaxial compressive strength over biaxial compressive strength or uniaxial compressive strength is dependent on the middle stress. The experimental data is useful for precise analysis of concrete member or concrete structure under the action complex stress state.

  17. DT-Diaphorase as a Bifunctional Enzyme Label That Allows Rapid Enzymatic Amplification and Electrochemical Redox Cycling.

    Science.gov (United States)

    Kang, Cheolho; Kang, Juyeon; Lee, Nam-Sihk; Yoon, Young Ho; Yang, Haesik

    2017-08-01

    The most common enzyme labels in enzyme-linked immunosorbent assays are alkaline phosphatase and horseradish peroxidase, which, however, have some limitations for use in electrochemical immunosensors. This Article reports that the small and thermostable DT-diaphorase (DT-D) and electrochemically inactive 4-nitroso-1-naphthol (4-NO-1-N) can be used as a bifunctional enzyme label and a rapidly reacting substrate, respectively, for electrochemical immunosensors. This enzyme-substrate combination allows high signal amplification via rapid enzymatic amplification and electrochemical redox cycling. DT-D can convert an electrochemically inactive nitroso or nitro compound into an electrochemically active amine compound, which can then be involved in electrochemical-chemical (EC) and electrochemical-enzymatic (EN) redox cycling. Six nitroso and nitro compounds are tested in terms of signal-to-background ratio. Among them, 4-NO-1-N exhibits the highest signal-to-background ratio. The electrochemical immunosensor using DT-D and 4-NO-1-N detects parathyroid hormone (PTH) in phosphate-buffered saline containing bovine serum albumin over a wide range of concentrations with a low detection limit of 2 pg/mL. When the PTH concentration in clinical serum samples is measured using the developed immunosensor, the calculated concentrations are in good agreement with the concentrations obtained using a commercial instrument. Thus, the use of DT-D as an enzyme label is highly promising for sensitive electrochemical detection and point-of-care testing.

  18. 3D noninvasive, high-resolution imaging using a photoacoustic tomography (PAT) system and rapid wavelength-cycling lasers

    Science.gov (United States)

    Sampathkumar, Ashwin; Gross, Daniel; Klosner, Marc; Chan, Gary; Wu, Chunbai; Heller, Donald F.

    2015-05-01

    Globally, cancer is a major health issue as advances in modern medicine continue to extend the human life span. Breast cancer ranks second as a cause of cancer death in women in the United States. Photoacoustic (PA) imaging (PAI) provides high molecular contrast at greater depths in tissue without the use of ionizing radiation. In this work, we describe the development of a PA tomography (PAT) system and a rapid wavelength-cycling Alexandrite laser designed for clinical PAI applications. The laser produces 450 mJ/pulse at 25 Hz to illuminate the entire breast, which eliminates the need to scan the laser source. Wavelength cycling provides a pulse sequence in which the output wavelength repeatedly alternates between 755 nm and 797 nm rapidly within milliseconds. We present imaging results of breast phantoms with inclusions of different sizes at varying depths, obtained with this laser source, a 5-MHz 128-element transducer and a 128-channel Verasonics system. Results include PA images and 3D reconstruction of the breast phantom at 755 and 797 nm, delineating the inclusions that mimic tumors in the breast.

  19. Experimental validation of analytical models for a rapid determination of cycle parameters in thermoplastic injection molding

    Science.gov (United States)

    Pignon, Baptiste; Sobotka, Vincent; Boyard, Nicolas; Delaunay, Didier

    2017-10-01

    Two different analytical models were presented to determine cycle parameters of thermoplastics injection process. The aim of these models was to provide quickly a first set of data for mold temperature and cooling time. The first model is specific to amorphous polymers and the second one is dedicated to semi-crystalline polymers taking the crystallization into account. In both cases, the nature of the contact between the polymer and the mold could be considered as perfect or not (thermal contact resistance was considered). Results from models are compared with experimental data obtained with an instrumented mold for an acrylonitrile butadiene styrene (ABS) and a polypropylene (PP). Good agreements were obtained for mold temperature variation and for heat flux. In the case of the PP, the analytical crystallization times were compared with those given by a coupled model between heat transfer and crystallization kinetics.

  20. Silica cycling and isotopic composition in northern Marguerite Bay on the rapidly-warming western Antarctic Peninsula

    Science.gov (United States)

    Annett, Amber L.; Henley, Sian F.; Venables, Hugh J.; Meredith, Michael P.; Clarke, Andrew; Ganeshram, Raja S.

    2017-05-01

    The Southern Ocean is a key region for silica (Si) cycling, and the isotopic signatures established here influence the rest of the world's oceans. The climate and ecosystem of the Southern Ocean are changing rapidly, with the potential to impact Si cycling and isotope dynamics. This study examines high-resolution time-series dataset of dissolved Si concentrations and isotopic signatures, particulate Si concentrations and diatom speciation at a coastal site on the western Antarctic Peninsula (WAP), in order to characterise changes in Si cycling with respect to changes occurring in productivity and diatom assemblages. Dissolved and particulate Si phases reflect the dominant control of biological uptake, and combined with isotopic fractionation were consistent with a season of low/intermediate productivity. Biogenic Si is tightly coupled to both chlorophyll and particulate organic carbon at the sampling site, consistent with diatom-dominated phytoplankton assemblages along the WAP. Variability in diatom speciation has a negligible impact on the isotopic signature of dissolved Si in surface waters, although this is unlikely to hold for sediments due to differential dissolution of diatom species. A continued decline in diatom productivity along the WAP would likely result in an increasing unused Si inventory, which can potentially feed back into Si-limited areas, promoting diatom growth and carbon drawdown further afield.

  1. Rapid ammonia gas transport accounts for futile transmembrane cycling under NH3/NH4+ toxicity in plant roots.

    Science.gov (United States)

    Coskun, Devrim; Britto, Dev T; Li, Mingyuan; Becker, Alexander; Kronzucker, Herbert J

    2013-12-01

    Futile transmembrane NH3/NH4(+) cycling in plant root cells, characterized by extremely rapid fluxes and high efflux to influx ratios, has been successfully linked to NH3/NH4(+) toxicity. Surprisingly, the fundamental question of which species of the conjugate pair (NH3 or NH4(+)) participates in such fluxes is unresolved. Using flux analyses with the short-lived radioisotope (13)N and electrophysiological, respiratory, and histochemical measurements, we show that futile cycling in roots of barley (Hordeum vulgare) seedlings is predominately of the gaseous NH3 species, rather than the NH4(+) ion. Influx of (13)NH3/(13)NH4(+), which exceeded 200 µmol g(-1) h(-1), was not commensurate with membrane depolarization or increases in root respiration, suggesting electroneutral NH3 transport. Influx followed Michaelis-Menten kinetics for NH3 (but not NH4(+)), as a function of external concentration (Km = 152 µm, Vmax = 205 µmol g(-1) h(-1)). Efflux of (13)NH3/(13)NH4(+) responded with a nearly identical Km. Pharmacological characterization of influx and efflux suggests mediation by aquaporins. Our study fundamentally revises the futile-cycling model by demonstrating that NH3 is the major permeating species across both plasmalemma and tonoplast of root cells under toxicity conditions.

  2. Bipolar Items

    Directory of Open Access Journals (Sweden)

    Nishiguchi Sumiyo

    2016-12-01

    Full Text Available This article asserts that the Japanese wide-scope mo ‘even’ in simple sentences are bipolar items (BPIs antilicensed or forbidden by negation and licensed in a non-monotonic (NM environment. BPIs share the features of negative polarity items (NPIs as well as positive polarity items (PPIs. The Dutch ooit ‘ever’, the Serbo-Croatian i-series ‘and/even’, and the Hungarian is-series ‘and/even’ are antilicensed by clausemate negation and licensed by extraclausal negation (van der Wouden, 1997; Progovac, 1994; Szabolcsi, 2002 or non-monotonic negative (and positive, for Serbo-Croatian emotive predicates. Adding an NPI rescues BPIs in uncomfortable clausemate negation.

  3. Generalized bipolar product and sum

    OpenAIRE

    Greco,Salvatore; Mesiar, Radko; Rindone, Fabio

    2016-01-01

    Aggregation functions on [0, 1] with annihilator 0 can be seen as a generalized product on [0, 1]. We study the generalized product on the bipolar scale [−1, 1], stressing the axiomatic point of view ( compare also [9]). Based on newly introduced bipolar properties, such as the bipolar increasingness, bipolar unit element, bipolar idempotent element, several kinds of generalized bipolar product are introduced and studied. A special stress is put on bipolar semicopulas, bipolar quasi-copulas a...

  4. Worker dose under high-power operation of the J-PARC 3 GeV Rapid Cycling Synchrotron

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    Yamamoto Kazami

    2017-01-01

    Full Text Available The J-PARC 3 GeV Rapid Cycling Synchrotron (RCS delivers a 1-MW, high-intensity beam to facilities downstream. In such high-intensity accelerators, the operational beam intensity is limited to keep worker exposure to the residual dose within acceptable tolerances. Therefore, we continue to pursue accelerator commissioning that reduces beam loss. In order to achieve further high-intensity operation, the J-PARC accelerator system has been drastically upgraded over the past two years. As a result, it was found that beam loss decreased, whereas output power increased; the residual doses were kept at the same level or decreased in RCS. A malfunction of a collimator occurred in April 2016, and we replaced it to a spare duct in a hurry. The broken collimator was higher activated, but exposure to workers was kept within the acceptable level.

  5. Dual-harmonic auto voltage control for the rapid cycling synchrotron of the Japan Proton Accelerator Research Complex

    Directory of Open Access Journals (Sweden)

    Fumihiko Tamura

    2008-07-01

    Full Text Available The dual-harmonic operation, in which the accelerating cavities are driven by the superposition of the fundamental and the second harmonic rf voltage, is useful for acceleration of the ultrahigh intensity proton beam in the rapid cycling synchrotron (RCS of Japan Proton Accelerator Research Complex (J-PARC. However, the precise and fast voltage control of the harmonics is necessary to realize the dual-harmonic acceleration. We developed the dual-harmonic auto voltage control system for the J-PARC RCS. We describe details of the design and the implementation. Various tests of the system are performed with the RCS rf system. Also, a preliminary beam test has been done. We report the test results.

  6. Breakage-fusion-bridge cycles and large insertions contribute to the rapid evolution of accessory chromosomes in a fungal pathogen.

    Science.gov (United States)

    Croll, Daniel; Zala, Marcello; McDonald, Bruce A

    2013-06-01

    Chromosomal rearrangements are a major driver of eukaryotic genome evolution, affecting speciation, pathogenicity and cancer progression. Changes in chromosome structure are often initiated by mis-repair of double-strand breaks in the DNA. Mis-repair is particularly likely when telomeres are lost or when dispersed repeats misalign during crossing-over. Fungi carry highly polymorphic chromosomal complements showing substantial variation in chromosome length and number. The mechanisms driving chromosome polymorphism in fungi are poorly understood. We aimed to identify mechanisms of chromosomal rearrangements in the fungal wheat pathogen Zymoseptoria tritici. We combined population genomic resequencing and chromosomal segment PCR assays with electrophoretic karyotyping and resequencing of parents and offspring from experimental crosses to show that this pathogen harbors a highly diverse complement of accessory chromosomes that exhibits strong global geographic differentiation in numbers and lengths of chromosomes. Homologous chromosomes carried highly differentiated gene contents due to numerous insertions and deletions. The largest accessory chromosome recently doubled in length through insertions totaling 380 kb. Based on comparative genomics, we identified the precise breakpoint locations of these insertions. Nondisjunction during meiosis led to chromosome losses in progeny of three different crosses. We showed that a new accessory chromosome emerged in two viable offspring through a fusion between sister chromatids. Such chromosome fusion is likely to initiate a breakage-fusion-bridge (BFB) cycle that can rapidly degenerate chromosomal structure. We suggest that the accessory chromosomes of Z. tritici originated mainly from ancient core chromosomes through a degeneration process that included BFB cycles, nondisjunction and mutational decay of duplicated sequences. The rapidly evolving accessory chromosome complement may serve as a cradle for adaptive evolution in

  7. Commercialization of Fuel Cell Bipolar Plate Manufacturing by Electromagnetic Forming

    OpenAIRE

    Daehn, G. S.; Hatkevich, S.; Shang, J; Wilkerson, L

    2010-01-01

    The cost of manufacturing bipolar plates is a major component to the overall cost structure of a Proton Exchange Membrane (PEM) fuel cell stack. To achieve the commercialization of PEM fuel cells, a high volume and low cost manufacturing process for the bipolar plate must be developed. American Trim has identified high velocity electromagnetic forming as a suitable technology to manufacture metallic fuel cell bipolar plates, because of its low capital cost, flexible tooling and rapid prototyp...

  8. Novel Design Integrating a Microwave Applicator into a Crystallizer for Rapid Temperature Cycling. A Direct Nucleation Control Study

    Science.gov (United States)

    2017-01-01

    The control of nucleation in crystallization processes is a challenging task due to the often lacking knowledge on the process kinetics. Inflexible (predetermined) control strategies fail to grow the nucleated crystals to the desired quality because of the variability in the process conditions, disturbances, and the stochastic nature of crystal nucleation. Previously, the concept of microwave assisted direct nucleation control (DNC) was demonstrated in a laboratory setup to control the crystal size distribution in a batch crystallization process by manipulating the number of particles in the system. Rapid temperature cycling was used to manipulate the super(under)saturation and hence the number of crystals. The rapid heating response achieved with the microwave heating improved the DNC control efficiency, resulting in halving of the batch time. As an extension, this work presents a novel design in which the microwave applicator is integrated in the crystallizer, hence avoiding the external loop though the microwaves oven. DNC implemented in the 4 L unseeded crystallizer, at various count set points, resulted in strong efficiency enhancement of DNC, when compared to the performance with a slow responding system. The demonstrated crystallizer design is a basis for extending the enhanced process control opportunity to other applications. PMID:28729813

  9. A rapid and systematic review and economic evaluation of the clinical and cost-effectiveness of newer drugs for treatment of mania associated with bipolar affective disorder.

    Science.gov (United States)

    Bridle, C; Palmer, S; Bagnall, A-M; Darba, J; Duffy, S; Sculpher, M; Riemsma, R

    2004-05-01

    To evaluate the clinical and cost-effectiveness of quetiapine, olanzapine and valproate semisodium in the treatment of mania associated with bipolar disorder. Electronic databases; industry submissions made to the National Institute for Clinical Excellence. Randomised trials and economic evaluations that evaluated the effectiveness of quetiapine, olanzapine or valproate semisodium in the treatment of mania associated with bipolar disorder were selected for inclusion. Data were extracted by one reviewer into a Microsoft Access database and checked for quality and accuracy by a second. The quality of the cost-effectiveness studies was assessed using a checklist updated from that developed by Drummond and colleagues. Relative risk and mean difference data were presented as Forest plots but only pooled where this made sense clinically and statistically. Studies were grouped by drug and, within each drug, by comparator used. Chi-squared tests of heterogeneity were performed for the outcomes if pooling was indicated. A probabilistic model was developed to estimate costs from the perspective of the NHS, and health outcomes in terms of response rate, based on an improvement of at least 50% in a patient's baseline manic symptoms derived from an interview-based mania assessment scale. The model evaluated the cost-effectiveness of the alternative drugs when used as part of treatment for the acute manic episode only. Eighteen randomised trials met the inclusion criteria. Aspects of three of the quetiapine studies were commercial-in-confidence. The quality of the included trials was limited and overall, key methodological criteria were not met in most trials. Quetiapine, olanzapine and valproate semisodium appear superior to placebo in reducing manic symptoms, but may cause side-effects. There appears to be little difference between these treatments and lithium in terms of effectiveness, but quetiapine is associated with somnolence and weight gain, whereas lithium is associated

  10. Treatment of bipolar disorder: a complex treatment for a multi-faceted disorder

    Directory of Open Access Journals (Sweden)

    Fresno David

    2007-10-01

    Full Text Available Abstract Background Manic-depression or bipolar disorder (BD is a multi-faceted illness with an inevitably complex treatment. Methods This article summarizes the current status of our knowledge and practice of its treatment. Results It is widely accepted that lithium is moderately useful during all phases of bipolar illness and it might possess a specific effectiveness on suicidal prevention. Both first and second generation antipsychotics are widely used and the FDA has approved olanzapine, risperidone, quetiapine, ziprasidone and aripiprazole for the treatment of acute mania. These could also be useful in the treatment of bipolar depression, but only limited data exists so far to support the use of quetiapine monotherapy or the olanzapine-fluoxetine combination. Some, but not all, anticonvulsants possess a broad spectrum of effectiveness, including mixed dysphoric and rapid-cycling forms. Lamotrigine may be effective in the treatment of depression but not mania. Antidepressant use is controversial. Guidelines suggest their cautious use in combination with an antimanic agent, because they are supposed to induce switching to mania or hypomania, mixed episodes and rapid cycling. Conclusion The first-line psychosocial intervention in BD is psychoeducation, followed by cognitive-behavioral therapy. Other treatment options include Electroconvulsive therapy and transcranial magnetic stimulation. There is a gap between the evidence base, which comes mostly from monotherapy trials, and clinical practice, where complex treatment regimens are the rule.

  11. Bipolar Neutrosophic Graph Structures

    OpenAIRE

    Akram, Muhammad; Sitara, Muzzamal

    2017-01-01

    In this research study, we introduce the concept of bipolar single-valued neutrosophic graph structures.We discuss certain notions of bipolar single-valued neutrosophic graph structures with examples.We present some methods of construction of bipolar single-valued neutrosophic graph structures.We also investigate some of their prosperities.

  12. Psychotic and Bipolar Disorders: Bipolar Disorder.

    Science.gov (United States)

    Holder, Sarah D

    2017-04-01

    Bipolar disorder is a severe chronic mental illness that affects a large number of individuals. This disorder is separated into two major types, bipolar I disorder, with mania and typically recurrent depression, and bipolar II disorder, with recurrent major depression and hypomania. Patients with bipolar disorder spend the majority of time experiencing depression, and this typically is the presenting symptom. Because outcomes are improved with earlier diagnosis and treatment, physicians should maintain a high index of suspicion for bipolar disorder. The most effective long-term treatments are lithium and valproic acid, although other drugs also are used. In addition to referral to a mental health subspecialist for initiation and management of drug treatment, patients with bipolar disorder should be provided with resources for psychotherapy. Several comorbidities commonly associated with bipolar disorder include other mental disorders, substance use disorders, migraine headaches, chronic pain, stroke, metabolic syndrome, and cardiovascular disease. Family physicians who care for patients with bipolar disorder should focus their efforts on prevention and management of comorbidities. These patients should be assessed continually for risk of suicide because they are at high risk and their suicide attempts tend to be successful. Written permission from the American Academy of Family Physicians is required for reproduction of this material in whole or in part in any form or medium.

  13. Rapid freeze-drying cycle optimization using computer programs developed based on heat and mass transfer models and facilitated by tunable diode laser absorption spectroscopy (TDLAS).

    Science.gov (United States)

    Kuu, Wei Y; Nail, Steven L

    2009-09-01

    Computer programs in FORTRAN were developed to rapidly determine the optimal shelf temperature, T(f), and chamber pressure, P(c), to achieve the shortest primary drying time. The constraint for the optimization is to ensure that the product temperature profile, T(b), is below the target temperature, T(target). Five percent mannitol was chosen as the model formulation. After obtaining the optimal sets of T(f) and P(c), each cycle was assigned with a cycle rank number in terms of the length of drying time. Further optimization was achieved by dividing the drying time into a series of ramping steps for T(f), in a cascading manner (termed the cascading T(f) cycle), to further shorten the cycle time. For the purpose of demonstrating the validity of the optimized T(f) and P(c), four cycles with different predicted lengths of drying time, along with the cascading T(f) cycle, were chosen for experimental cycle runs. Tunable diode laser absorption spectroscopy (TDLAS) was used to continuously measure the sublimation rate. As predicted, maximum product temperatures were controlled slightly below the target temperature of -25 degrees C, and the cascading T(f)-ramping cycle is the most efficient cycle design. In addition, the experimental cycle rank order closely matches with that determined by modeling.

  14. Integrated Neurobiology of Bipolar Disorder

    Science.gov (United States)

    Maletic, Vladimir; Raison, Charles

    2014-01-01

    From a neurobiological perspective there is no such thing as bipolar disorder. Rather, it is almost certainly the case that many somewhat similar, but subtly different, pathological conditions produce a disease state that we currently diagnose as bipolarity. This heterogeneity – reflected in the lack of synergy between our current diagnostic schema and our rapidly advancing scientific understanding of the condition – limits attempts to articulate an integrated perspective on bipolar disorder. However, despite these challenges, scientific findings in recent years are beginning to offer a provisional “unified field theory” of the disease. This theory sees bipolar disorder as a suite of related neurodevelopmental conditions with interconnected functional abnormalities that often appear early in life and worsen over time. In addition to accelerated loss of volume in brain areas known to be essential for mood regulation and cognitive function, consistent findings have emerged at a cellular level, providing evidence that bipolar disorder is reliably associated with dysregulation of glial–neuronal interactions. Among these glial elements are microglia – the brain’s primary immune elements, which appear to be overactive in the context of bipolarity. Multiple studies now indicate that inflammation is also increased in the periphery of the body in both the depressive and manic phases of the illness, with at least some return to normality in the euthymic state. These findings are consistent with changes in the hypothalamic–pituitary–adrenal axis, which are known to drive inflammatory activation. In summary, the very fact that no single gene, pathway, or brain abnormality is likely to ever account for the condition is itself an extremely important first step in better articulating an integrated perspective on both its ontological status and pathogenesis. Whether this perspective will translate into the discovery of innumerable more homogeneous forms of

  15. DNA-based genetic markers for Rapid Cycling Brassica rapa (Fast Plants type designed for the teaching laboratory.

    Directory of Open Access Journals (Sweden)

    Eryn E. Slankster

    2012-06-01

    Full Text Available We have developed DNA-based genetic markers for rapid-cycling Brassica rapa (RCBr, also known as Fast Plants. Although markers for Brassica rapa already exist, ours were intentionally designed for use in a teaching laboratory environment. The qualities we selected for were robust amplification in PCR, polymorphism in RCBr strains, and alleles that can be easily resolved in simple agarose slab gels. We have developed two single nucleotide polymorphism (SNP based markers and 14 variable number tandem repeat (VNTR-type markers spread over four chromosomes. The DNA sequences of these markers represent variation in a wide range of genomic features. Among the VNTR-type markers, there are examples of variation in a nongenic region, variation within an intron, and variation in the coding sequence of a gene. Among the SNP-based markers there are examples of polymorphism in intronic DNA and synonymous substitution in a coding sequence. Thus these markers can serve laboratory exercises in both transmission genetics and molecular biology.

  16. Genetic analysis of morphological traits in a new, versatile, rapid-cycling Brassica rapa recombinant inbred line population

    Science.gov (United States)

    Bagheri, Hedayat; El-Soda, Mohamed; van Oorschot, Inge; Hanhart, Corrie; Bonnema, Guusje; Jansen-van den Bosch, Tanja; Mank, Rolf; Keurentjes, Joost J. B.; Meng, Lin; Wu, Jian; Koornneef, Maarten; Aarts, Mark G. M.

    2012-01-01

    A recombinant inbred line (RIL) population was produced based on a wide cross between the rapid-cycling and self-compatible genotypes L58, a Caixin vegetable type, and R-o-18, a yellow sarson oil type. A linkage map based on 160 F7 lines was constructed using 100 Single nucleotide polymorphisms (SNPs), 130 AFLP®, 27 InDel, and 13 publicly available SSR markers. The map covers a total length of 1150 centiMorgan (cM) with an average resolution of 4.3 cM/marker. To demonstrate the versatility of this new population, 17 traits, related to plant architecture and seed characteristics, were subjected to quantitative trait loci (QTL) analysis. A total of 47 QTLs were detected, each explaining between 6 and 54% of the total phenotypic variance for the concerned trait. The genetic analysis shows that this population is a useful new tool for analyzing genetic variation for interesting traits in B. rapa, and for further exploitation of the recent availability of the B. rapa whole genome sequence for gene cloning and gene function analysis. PMID:22912644

  17. Genetic analysis of morphological traits in a new, versatile, rapid-cycling Brassica rapa recombinant inbred line population

    Directory of Open Access Journals (Sweden)

    Hedayat eBagheri

    2012-08-01

    Full Text Available A recombinant inbred line (RIL population was produced based on a wide cross between the rapid-cycling and self-compatible genotypes L58, a Caixin vegetable type, and R-o-18, a yellow sarson oil type. A linkage map based on 160 F7 lines was constructed using 100 SNP, 130 AFLP®, 27 InDel and 13 publicly available SSR markers. The map covers a total length of 1150 cM with an average resolution of 4.3 cM/marker. To demonstrate the versatility of this new population, 17 traits, related to plant architecture and seed characteristics, were subjected to QTL analysis. A total of 47 QTLs were detected, each explaining between 6 to 54% of the total phenotypic variance for the concerned trait. The genetic analysis shows that this population is a useful new tool for analyzing genetic variation for interesting traits in B. rapa, and for further exploitation of the recent availability of the B. rapa whole genome sequence for gene cloning and gene function analysis.

  18. DNA-Based Genetic Markers for Rapid Cycling Brassica Rapa (Fast Plants Type) Designed for the Teaching Laboratory

    Science.gov (United States)

    Slankster, Eryn E.; Chase, Jillian M.; Jones, Lauren A.; Wendell, Douglas L.

    2012-01-01

    We have developed DNA-based genetic markers for rapid cycling Brassica rapa (RCBr), also known as Fast Plants. Although markers for B. rapa already exist, ours were intentionally designed for use in a teaching laboratory environment. The qualities we selected for were robust amplification in PCR, polymorphism in RCBr strains, and alleles that can be easily resolved in simple agarose slab gels. We have developed two single nucleotide polymorphism (SNP) based markers and 14 variable number tandem repeat (VNTR)-type markers spread over four chromosomes. The DNA sequences of these markers represent variation in a wide range of genomic features. Among the VNTR-type markers, there are examples of variation in a non-genic region, variation within an intron, and variation in the coding sequence of a gene. Among the SNP-based markers there are examples of polymorphism in intronic DNA and synonymous substitution in a coding sequence. Thus these markers can serve laboratory exercises in both transmission genetics and molecular biology. PMID:22675329

  19. Teaching Human Genetics with Mustard: Rapid Cycling "Brassica rapa" (Fast Plants Type) as a Model for Human Genetics in the Classroom Laboratory

    Science.gov (United States)

    Wendell, Douglas L.; Pickard, Dawn

    2007-01-01

    We have developed experiments and materials to model human genetics using rapid cycling "Brassica rapa", also known as Fast Plants. Because of their self-incompatibility for pollination and the genetic diversity within strains, "B. rapa" can serve as a relevant model for human genetics in teaching laboratory experiments. The experiment presented…

  20. Manic Episode after Ventricular-Peritoneal Shunt Replacement in a Patient with Radiation-Induced Hydrocephalus: The Role of Lifetime Subthreshold Bipolar Features

    Directory of Open Access Journals (Sweden)

    Antonio Callari

    2014-01-01

    Full Text Available We present a case report of a woman hospitalized for a ventricular-peritoneal shunting replacement, who developed a manic episode with psychotic symptoms after hydrocephalus resolution. We have no knowledge of cases of manic episodes due to hydrocephalus resolution by ventricular-peritoneal shunt replacement, although previous case reports have suggested that hydrocephalus might induce rapid-onset affective episodes or mood cycles. The patient’s history revealed the lifetime presence of signs and features belonging to the subthreshold bipolar spectrum, in absence of previous full-blown episodes of a bipolar disorder. Our hypothesis is that such lifetime sub-threshold bipolar features represented precursors of the subsequent full-blown manic episode, triggered by an upregulated binding of striatum D2 receptors after the ventricular-peritoneal shunt replacement.

  1. Bipolar soft connected, bipolar soft disconnected and bipolar soft compact spaces

    Directory of Open Access Journals (Sweden)

    Muhammad Shabir

    2017-06-01

    Full Text Available Bipolar soft topological spaces are mathematical expressions to estimate interpretation of data frameworks. Bipolar soft theory considers the core features of data granules. Bipolarity is important to distinguish between positive information which is guaranteed to be possible and negative information which is forbidden or surely false. Connectedness and compactness are the most important fundamental topological properties. These properties highlight the main features of topological spaces and distinguish one topology from another. Taking this into account, we explore the bipolar soft connectedness, bipolar soft disconnectedness and bipolar soft compactness properties for bipolar soft topological spaces. Moreover, we introduce the notion of bipolar soft disjoint sets, bipolar soft separation, and bipolar soft hereditary property and study on bipolar soft connected and disconnected spaces. By giving the detailed picture of bipolar soft connected and disconnected spaces we investigate bipolar soft compact spaces and derive some results related to this concept.

  2. The role of sleep in bipolar disorder

    Directory of Open Access Journals (Sweden)

    Gold AK

    2016-06-01

    Full Text Available Alexandra K Gold,1 Louisa G Sylvia,1,2 1Department of Psychiatry, Massachusetts General Hospital, 2Harvard Medical School, Boston, MA, USA Abstract: Bipolar disorder is a serious mental illness characterized by alternating periods of elevated and depressed mood. Sleep disturbances in bipolar disorder are present during all stages of the condition and exert a negative impact on overall course, quality of life, and treatment outcomes. We examine the partnership between circadian system (process C functioning and sleep–wake homeostasis (process S on optimal sleep functioning and explore the role of disruptions in both systems on sleep disturbances in bipolar disorder. A convergence of evidence suggests that sleep problems in bipolar disorder result from dysregulation across both process C and process S systems. Biomarkers of depressive episodes include heightened fragmentation of rapid eye movement (REM sleep, reduced REM latency, increased REM density, and a greater percentage of awakenings, while biomarkers of manic episodes include reduced REM latency, greater percentage of stage I sleep, increased REM density, discontinuous sleep patterns, shortened total sleep time, and a greater time awake in bed. These findings highlight the importance of targeting novel treatments for sleep disturbance in bipolar disorder. Keywords: bipolar disorder, circadian rhythms, sleep–wake homeostasis

  3. Profile of aripiprazole in the treatment of bipolar disorder in children and adolescents

    Directory of Open Access Journals (Sweden)

    Kirino E

    2014-11-01

    Full Text Available Eiji Kirino1–3 1Department of Psychiatry, Juntendo University School of Medicine, 2Department of Psychiatry, Juntendo University Shizuoka Hospital, 3Juntendo Institute of Mental Health, Shizuoka, Japan Abstract: Bipolar disorder is a pernicious illness. Compared with the later-onset form, early onset bipolar disorder is associated with worse psychosocial outcomes, and is characterized by rapid cycling and increased risks of substance abuse and suicide attempts. Controlling mood episodes and preventing relapse in this group of pediatric patients requires careful treatment. Here, we review the effectiveness of aripiprazole for bipolar disorder in children and adolescents, with discussion of this drug's unique pharmacological profile and various clinical study outcomes. Aripiprazole acts as a serotonin 5-HT2A receptor antagonist, as well as a partial agonist of the serotonin 5-HT1A and dopamine D2 receptors. It can be safely used in children and adolescents, as it is highly tolerated and shows lower rates of the side effects typically observed with other antipsychotic drugs, including sedation, weight gain, hyperprolactinemia, and extrapyramidal syndrome. The presently reviewed randomized controlled trials (RCTs and non-RCTs generally reported aripiprazole to be effective and well-tolerated in children and adolescents with bipolar disorder. However, due to the limited number of RCTs, the present conclusions must be evaluated cautiously. Furthermore, aripiprazole cannot yet be considered a preferred treatment for children and adolescents with bipolar disorder, as there is not yet evidence that aripiprazole shows greater efficacy compared to other second-generation antipsychotics. Additional data are needed from future head-to-head comparison studies. Keywords: child, mania, mixed state

  4. Clinical outcomes associated with comorbid posttraumatic stress disorder among patients with bipolar disorder.

    Science.gov (United States)

    Passos, Ives C; Jansen, Karen; Cardoso, Taiane de A; Colpo, Gabriela D; Zeni, Cristian P; Quevedo, Joao; Kauer-Sant'Anna, Márcia; Zunta-Soares, Giovanna; Soares, Jair C; Kapczinski, Flavio

    2016-05-01

    To assess clinical outcomes associated with the presence of a lifetime history of comorbid posttraumatic stress disorder in subjects with bipolar disorder. This cross-sectional study of 284 subjects with bipolar disorder (DSM-IV) assessed the association between lifetime comorbid posttraumatic stress disorder (DSM-IV) and clinical characteristics. Participants were included from January 2006 to June 2009. We assessed age at onset, number of mood episodes, presence of rapid cycling, first drug use, suicide attempts, hospitalizations, functional impairment, and quality of life. Diagnostic, clinical, and functional assessments were carried out using the Structured Clinical Interview for DSM-IV Axis I Disorders, patient edition (SCID-I/P), the Functioning Assessment Short Test, and the World Health Organization Quality of Life scale. The number of manic episodes as assessed by SCID-I/P was the primary outcome. The prevalence of lifetime comorbid posttraumatic stress disorder was 19.7% (56 subjects). Subjects with bipolar disorder and posttraumatic stress disorder had an accelerated course of illness, with a lower age at onset of manic/hypomanic episodes (P = .009) and earlier initiation of illicit drug use (P = .008). In addition, they were more likely to be younger when they received the diagnosis of bipolar disorder (P = .036) and had a higher number of manic/hypomanic episodes (P = .01). Quality of life was worse in all domains among subjects who presented the comorbidity, and rates of functional impairment were higher. Comorbid posttraumatic stress disorder was associated with increased morbidity and accelerated illness progression among subjects with bipolar disorder. © Copyright 2016 Physicians Postgraduate Press, Inc.

  5. Predominant polarity in bipolar disorders: Further evidence for the role of affective temperaments.

    Science.gov (United States)

    Azorin, J M; Adida, M; Belzeaux, R

    2015-08-15

    Literature suggests bipolars may differ in several features according to predominant polarity, but the role of temperaments remains controversial. The EPIDEP study was designed to identify bipolar patients among a large sample of major depressives. Only bipolars were included in the current study. Patients were subtyped as predominantly depressive (PD) and predominantly manic and hypomanic (PM) according to a broad (more episodes of a given polarity) and a narrow (2/3 of episodes of one polarity over the other) definition, and compared on their characteristics. Among 278 bipolars, 182 (79.8%) could be subtyped as PD and 46 (20.2%) as PM (broad definition); the respective proportions were of 111 (81.6%) and 25 (18.4%) using narrow definition. Expanding the definition added little in detecting differences between groups. Compared to PDs, PMs showed more psychosis, rapid cycling, stressors at onset, family history of affective illness, and manic first episode polarity; they also received more antipsychotics and lithium. The PDs showed more chronic depression, comorbid anxiety, and received more antidepressants, anticonvulsants and benzodiazepines. The following independent variables were associated with manic/hypomanic predominant polarity: cyclothymic temperament, first hospitalization≤25 years, hyperthymic temperament, and alcohol use (only for broad definition). Cross-sectional design, recall bias. Study findings are in accord with literature except for suicidality and mixicity which were related to predominant mania, and explained by higher levels of cyclothymic and hyperthymic temperaments. Temperaments may play a key role in the subtyping of bipolar patients according to predominant polarity, which warrants confirmation in prospective studies. Copyright © 2015 Elsevier B.V. All rights reserved.

  6. Thermal analysis of injection beam dump of high-intensity rapid-cycling synchrotron in J-PARC

    Science.gov (United States)

    Kamiya, J.; Saha, P. K.; Yamamoto, K.; Kinsho, M.; Nihei, T.

    2017-10-01

    The beam dump at the beam injection area in the J-PARC 3-GeV rapid cycling synchrotron (RCS) accepts beams that pass through the charge exchange foil without ideal electron stripping during the multi-turn beam injection. The injection beam dump consists of the beam pipe, beam stopper, radiation shield, and cooling mechanism. The ideal beam power into the injection beam dump is 400 W in the case of design RCS extraction beam power of 1 MW with a healthy foil, which has 99.7 % charge stripping efficiency. On the other hand, as a radiation generator, the RCS is permitted to be operated with maximum average beam power of 4 kW into the injection beam dump based on the radiation shielding calculation, in consideration of lower charge stripping efficiency due to the foil deterioration. In this research, to evaluate the health of the RCS injection beam dump system from the perspective of the heat generation, a thermal analysis was performed based on the actual configuration with sufficiently large region, including the surrounding concrete and soil. The calculated temperature and heat flux density distribution showed the validity of the mesh spacing and model range. The calculation result showed that the dumped 4 kW beam causes the temperature to increase up to 330, 400, and 140 °C at the beam pipe, beam stopper, and radiation shield, respectively. Although these high temperatures induce stress in the constituent materials, the calculated stress values were lower than the ultimate tensile strength of each material. Transient temperature analysis of the beam stopper, which simulated the sudden break of the charge stripper foil, demonstrated that one bunched beam pulse with the maximum beam power does not lead to a serious rise in the temperature of the beam stopper. Furthermore, from the measured outgassing rate of stainless steel at high temperature, the rise in beam line pressure due to additive outgassing from the heated beam pipe was estimated to have a negligible

  7. Design and Development Comparison of Rapid Cycle Amine 1.0, 2.0, and 3.0

    Science.gov (United States)

    Chullen, Cinda; Campbell, Colin; Papale, William; Murray, Sean; Wichowski, Robert; Conger, Bruce; McMillin, Summer

    2016-01-01

    The development of the Rapid Cycle Amine (RCA) swing-bed technology for carbon dioxide (CO2) removal has been in progress since favorable results were published in 1996. Shortly thereafter, a prototype was designed, developed, and tested successfully and delivered to Johnson Space Center in 1999. An improved prototype (RCA 1.0) was delivered to NASA in 2006 and sized for the extravehicular activity (EVA). The RCA swing-bed technology is a regenerative system which employs two alternating solid-amine sorbent beds to remove CO2 and water. The two-bed design employs a chemisorption process whereby the beds alternate between adsorption and desorption. This process provides for an efficient RCA operation that enables one bed to be in adsorb (uptake) mode, while the other is in the desorb (regeneration) mode. The RCA has progressed through several iterations of technology readiness levels. Test articles have now been designed, developed, and tested for the advanced space suit portable life support system (PLSS) including RCA 1.0, RCA 2.0, and RCA 3.0. The RCA 3.0 was the most recent RCA fabrication and was delivered to NASA-JSC in June 2015. The RCA 1.0 test article was designed with a pneumatically actuated linear motion spool valve. The RCA 2.0 and 3.0 test articles were designed with a valve assembly which allows for switching between uptake and regeneration modes while minimizing gas volume losses to the vacuum source. RCA 2.0 and 3.0 also include an embedded controller design to control RCA operation and provide the capability of interfacing with various sensors and other ventilation loop components. The RCA technology is low power, small, and has fulfilled all test requirements levied upon the technology during development testing thus far. This paper will provide an overview of the design and development of RCA 1.0, 2.0 and 3.0 including detail differences between the design specifications of each. Nomenclature.

  8. Characterizing the Performance of a Proton-Transfer-Reaction Mass Spectrometer with a Rapid Cycling Tenax Preconcentrator

    Energy Technology Data Exchange (ETDEWEB)

    Garland, S.P.; Alexander, M.L.

    2006-01-01

    Volatile organic compounds (VOCs) are species of interest for atmospheric modeling, worker chemical exposure and medical studies. Sometimes the required detection limits for these compounds is below the capability of existing real-time instrumentation. Preconcentrators have been implemented as an inexpensive way to amplify chemical signals and improve detection limits. Proton-transfer-reaction mass spectrometry (PTR-MS) has been used as a tool for studying low concentrations of VOCs, but it lacks the capability to differentiate chemical signal contributions from isobaric compounds. In this work, behavior of a newly designed Tenax TA preconcentrator when coupled with a PTRMS is characterized. This novel preconcentrator design allows rapid temperature cycling, maintaining near real-time response. The preconcentrator was exposed to a sample gas of toluene in varying concentrations and loading times between and then thermally desorbed for analysis by PTR-MS. The effects of preconcentrating multiple analytes simultaneously were also investigated as well as the chromatographic effects of the preconcentrator. A linear behavior was observed when the integrated ion count rates (ICPS) from thermal desorption peaks were regressed against both varying loading times at a constant toluene concentration and varying concentrations with constant loading times. From these trends, it is possible to determine the concentration of a VOC by knowing its ICPS from thermal desorption peaks from a known preconcentration time. Peak height ion count rates representing ultimate detectability were amplified by factors up to 257 times the original signal, extending the range of the PTR-MS from 50pptv to nearly 250 parts per quadrillion. This corresponds to an ultimate sensitivity of 200 parts per quadrillion with 20 minute time resolution. Quantitative preconcentrator behavior was demonstrated using ICPS from these ion peaks and were amplified as much as 148 times their original signal. Results

  9. Coupling Computer-Aided Process Simulation and Estimations of Emissions and Land Use for Rapid Life Cycle Inventory Modeling

    Science.gov (United States)

    A methodology is described for developing a gate-to-gate life cycle inventory (LCI) of a chemical manufacturing process to support the application of life cycle assessment in the design and regulation of sustainable chemicals. The inventories were derived by first applying proces...

  10. Predictors of switch from depression to mania in bipolar disorder.

    Science.gov (United States)

    Niitsu, Tomihisa; Fabbri, Chiara; Serretti, Alessandro

    2015-01-01

    Manic switch is a relevant issue when treating bipolar depression. Some risk factors have been suggested, but unequivocal findings are lacking. We therefore investigated predictors of switch from depression to mania in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) sample. Manic switch was defined as a depressive episode followed by a (hypo)manic or mixed episode within the following 12 weeks. We assessed possible predictors of switch using generalized linear mixed models (GLMM). 8403 episodes without switch and 512 episodes with switch (1720 subjects) were included in the analysis. Several baseline variables were associated with a higher risk of switch. They were younger age, previous history of: rapid cycling, severe manic symptoms, suicide attempts, amphetamine use and some pharmacological and psychotherapeutic treatments. During the current depressive episode, the identified risk factors were: any possible mood elevation, multiple mania-associated symptoms with at least moderate severity, and comorbid panic attacks. In conclusion, our study suggests that both characteristics of the disease history and clinical features of the current depressive episode may be risk factors for manic switch. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Magnetic bipolar transistor

    OpenAIRE

    Fabian, Jaroslav; Zutic, Igor; Sarma, S. Das

    2003-01-01

    A magnetic bipolar transistor is a bipolar junction transistor with one or more magnetic regions, and/or with an externally injected nonequilibrium (source) spin. It is shown that electrical spin injection through the transistor is possible in the forward active regime. It is predicted that the current amplification of the transistor can be tuned by spin.

  12. Neuroprogression in bipolar disorder.

    Science.gov (United States)

    Schneider, Marguerite Reid; DelBello, Melissa P; McNamara, Robert K; Strakowski, Stephen M; Adler, Caleb M

    2012-06-01

    Recent theories regarding the neuropathology of bipolar disorder suggest that both neurodevelopmental and neurodegenerative processes may play a role. While magnetic resonance imaging has provided significant insight into the structural, functional, and connectivity abnormalities associated with bipolar disorder, research assessing longitudinal changes has been more limited. However, such research is essential to elucidate the pathophysiology of the disorder. The aim of our review is to examine the extant literature for developmental and progressive structural and functional changes in individuals with and at risk for bipolar disorder. We conducted a literature review using MEDLINE and the following search terms: bipolar disorder, risk, child, adolescent, bipolar offspring, MRI, fMRI, DTI, PET, SPECT, cross-sectional, longitudinal, progressive, and developmental. Further relevant articles were identified by cross-referencing with identified manuscripts. There is some evidence for developmental and progressive neurophysiological alterations in bipolar disorder, but the interpretation of correlations between neuroimaging findings and measures of illness exposure or age in cross-sectional studies must be performed with care. Prospective longitudinal studies placed in the context of normative developmental and atrophic changes in neural structures and pathways thought to be involved in bipolar disorder are needed to improve our understanding of the neurodevelopmental underpinnings and progressive changes associated with bipolar disorder. © 2012 John Wiley and Sons A/S.

  13. [Atypical bipolar disorders].

    Science.gov (United States)

    Gay, Christian

    2009-04-20

    Some epidemiologic data reveal how difficult detecting atypic bipolar disorders is: 9 years of progression before the diagnosis is properly established and a specific treatment is initiated, and intervention of 4 to 5 different specialists. Incomplete symptomatology, impulsive actions, periodic alcohol abuse, compulsive buying behaviors, acute delusional episodes, medicolegal actions and comorbidities can hide or modify bipolar symptomatology. Bipolarity should be systematically screened for in case of substance abuse (40 to 60 percent of bipolar disorders), anxiety disorders (panic disorder, generalized anxiety, obsessive-compulsive disorders etc.) and feeding disorders. In these various situations, history taking and clinical examination will help to detect signs of bipolarity: reaction to antidepressants, inefficiency, paradoxical worsening, development of behavior disorders and mood changes. Besides screening for thymic disorders, the examination will be completed by history taking of thymic disorders, suicide, toxic abuse, anxiety disorders, personal history of attention deficit hyperactivity disorder in childhood, depression or postpartum psychosis in women, as well as premenstrual depressive manifestations.

  14. The International College of Neuro-Psychopharmacology (CINP) Treatment Guidelines for Bipolar Disorder in Adults (CINP-BD-2017), Part 2: Review, Grading of the Evidence, and a Precise Algorithm.

    Science.gov (United States)

    Fountoulakis, Konstantinos N; Yatham, Lakshmi; Grunze, Heinz; Vieta, Eduard; Young, Allan; Blier, Pierre; Kasper, Siegfried; Moeller, Hans Jurgen

    2017-02-01

    The current paper includes a systematic search of the literature, a detailed presentation of the results, and a grading of treatment options in terms of efficacy and tolerability/safety. The PRISMA method was used in the literature search with the combination of the words 'bipolar,' 'manic,' 'mania,' 'manic depression,' and 'manic depressive' with 'randomized,' and 'algorithms' with 'mania,' 'manic,' 'bipolar,' 'manic-depressive,' or 'manic depression.' Relevant web pages and review articles were also reviewed. The current report is based on the analysis of 57 guideline papers and 531 published papers related to RCTs, reviews, posthoc, or meta-analysis papers to March 25, 2016. The specific treatment options for acute mania, mixed episodes, acute bipolar depression, maintenance phase, psychotic and mixed features, anxiety, and rapid cycling were evaluated with regards to efficacy. Existing treatment guidelines were also reviewed. Finally, Tables reflecting efficacy and recommendation levels were created that led to the development of a precise algorithm that still has to prove its feasibility in everyday clinical practice. A systematic literature search was conducted on the pharmacological treatment of bipolar disorder to identify all relevant random controlled trials pertaining to all aspects of bipolar disorder and graded the data according to a predetermined method to develop a precise treatment algorithm for management of various phases of bipolar disorder. It is important to note that the some of the recommendations in the treatment algorithm were based on the secondary outcome data from posthoc analyses.

  15. A temperature control method for shortening thermal cycling time to achieve rapid polymerase chain reaction (PCR) in a disposable polymer microfluidic device

    DEFF Research Database (Denmark)

    Bu, Minqiang; Perch-Nielsen, Ivan R.; Sørensen, Karen Skotte

    2013-01-01

    We present a temperature control method capable of effectively shortening the thermal cycling time of polymerase chain reaction (PCR) in a disposable polymer microfluidic device with an external heater and a temperature sensor. The method employs optimized temperature overshooting and undershooting...... steps to achieve a rapid ramping between the temperature steps for DNA denaturation, annealing and extension. The temperature dynamics within the microfluidic PCR chamber was characterized and the overshooting and undershooting parameters were optimized using the temperature-dependent fluorescence...

  16. A novel temperature control method for shortening thermal cycling time to achieve rapid polymerase chain reaction (PCR) in a disposable polymer microfluidic device

    DEFF Research Database (Denmark)

    Bu, Minqiang; R. Perch-Nielsen, Ivan; Sørensen, Karen Skotte

    We present a new temperature control method capable of effectively shortening the thermal cycling time of polymerase chain reaction (PCR) in a disposable polymer microfluidic device with external heater and temperature sensor. The method employs optimized temperature overshooting and undershooting...... steps to achieve a rapid ramping between the temperature steps for DNA denaturation, annealing and extension. The temperature dynamics within the microfluidic PCR chamber was characterized and the overshooting and undershooting parameters were optimized using the temperature dependent fluorescence...

  17. [Actigraphy in Bipolar Disorder and First Degree Relatives].

    Science.gov (United States)

    Andrade Carrillo, Rommel; Gómez Cano, Sujey; Palacio Ortiz, Juan David; García Valencia, Jenny

    2015-01-01

    Bipolar disorder is a disabling disease that involves a significant economic costs to the health system, making it is essential to investigate possible early predictors such as changes in sleep-wake cycle in high-risk populations. To review the available literature on alterations in the sleep-wake cycle and circadian rhythm in patients with bipolar disorder and their first degree relatives. A literature search was performed in the data bases, Access Medicine, ClinicalKey, EMBASE, JAMA, Lilacs, OVID, Oxford Journals, ScienceDirect, SciELO, APA y PsycNET. Articles in both English and Spanish were reviewed, without limits by study type. Actigraphy is a non-invasive, useful method for assessing sleep-wake cycle disturbances in the active phases of bipolar disorder, and during euthymia periods. Actigraphy showed good sensitivity to predict true sleep, but low specificity, compared with polysomnography. Although studies in bipolar offspring and relatives are scarce, they show sleep changes similar to bipolar patients. Actigraphy may be a good screening tool of sleep/wake cycle in patients with bipolar disorders, because it is economic, non-invasive and sensitive. Longitudinal studies are required to evaluate its potential use as a risk marker. Copyright © 2014 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  18. Properties of Bipolar Fuzzy Hypergraphs

    OpenAIRE

    Akram, M.; Dudek, W. A.; Sarwar, S.

    2013-01-01

    In this article, we apply the concept of bipolar fuzzy sets to hypergraphs and investigate some properties of bipolar fuzzy hypergraphs. We introduce the notion of $A-$ tempered bipolar fuzzy hypergraphs and present some of their properties. We also present application examples of bipolar fuzzy hypergraphs.

  19. Increased PKC activity and altered GSK3β/NMDAR function drive behavior cycling in HINT1-deficient mice: bipolarity or opposing forces.

    Science.gov (United States)

    Garzón-Niño, Javier; Rodríguez-Muñoz, María; Cortés-Montero, Elsa; Sánchez-Blázquez, Pilar

    2017-02-27

    Mice with histidine triad nucleotide-binding protein 1 (HINT1) deletion exhibit manic-like symptoms that evolve into depressive-like behavior in response to stressful paradigms. Molecular and electrophysiological studies have indicated that HINT1-/- mice exhibit increased PKC, PKA, and GSK3β activities, as well as glutamate N-methyl-D-aspartate receptor (NMDAR)/α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic receptor (AMPAR) and NR2B/NR2A subunit ratios. Pharmacological interventions stabilized their behavior but through different mechanisms. GSK3β inhibitors and valproate directly attenuated the expression of the manic-like symptoms, whereas PKC inhibition, lamotrigine, or risperidone promoted NMDAR-mediated depressive-like behaviors that counterbalanced the preexisting manic-like symptoms. Naïve HINT1-/- mice exposed to stressful paradigms rapidly manifested depressive-like behaviors in subsequent stressful situations, a capacity that persisted for a couple of weeks thereafter. During the depressive-like phase, citalopram, amitriptyline and MK801 precipitated manic-like behaviors in stressed HINT1-/- mice. Notably, the antagonism of NMDARs prevented HINT1-/- mice from alternating behaviors in response to stress. A comparison with "manic" Black Swiss mice indicated that in HINT1-/- mice, PKC supports manic-like symptoms and reduces the expression of depressive-like behaviors via activation of GSK3β and regulation of NR2B-enriched NMDARs. HINT1-/- mice represent a suitable model for studying human BPD and may facilitate the identification of novel targets and drugs to treat this mental disorder.

  20. The role of sleep in bipolar disorder

    Science.gov (United States)

    Gold, Alexandra K; Sylvia, Louisa G

    2016-01-01

    Bipolar disorder is a serious mental illness characterized by alternating periods of elevated and depressed mood. Sleep disturbances in bipolar disorder are present during all stages of the condition and exert a negative impact on overall course, quality of life, and treatment outcomes. We examine the partnership between circadian system (process C) functioning and sleep–wake homeostasis (process S) on optimal sleep functioning and explore the role of disruptions in both systems on sleep disturbances in bipolar disorder. A convergence of evidence suggests that sleep problems in bipolar disorder result from dysregulation across both process C and process S systems. Biomarkers of depressive episodes include heightened fragmentation of rapid eye movement (REM) sleep, reduced REM latency, increased REM density, and a greater percentage of awakenings, while biomarkers of manic episodes include reduced REM latency, greater percentage of stage I sleep, increased REM density, discontinuous sleep patterns, shortened total sleep time, and a greater time awake in bed. These findings highlight the importance of targeting novel treatments for sleep disturbance in bipolar disorder. PMID:27418862

  1. Bipolarity and the relational division

    OpenAIRE

    Tamani, Nouredine; Lietard, Ludovic; Rocacher, Daniel

    2011-01-01

    International audience; A fuzzy bipolar relation is a relation defined by a fuzzy bipolar condition, which could be interpreted as an association of a constraint and a wish. In this context, the extension of the relational division operation to bipolarity is studied in this paper. Firstly, we define a bipolar division when the involved relations are crisp. Then, we define, from the semantic point of view, several forms of bipolar division when the involved relations are defined by fuzzy bipol...

  2. Neuroinflammation in bipolar disorders

    Directory of Open Access Journals (Sweden)

    Georgios D Kotzalidis

    2015-01-01

    Full Text Available Recent literature based on peripheral immunity findings speculated that neuroinflammation, with its connection to microglial activation, is linked to bipolar disorder. The endorsement of the neuroinflammatory hypotheses of bipolar disorder requires the demonstration of causality, which requires longitudinal studies. We aimed to review the evidence for neuroinflammation as a pathogenic mechanism of the bipolar disorder. We carried out a hyper inclusive PubMed search using all appropriate neuroinflammation-related terms and crossed them with bipolar disorder-related terms. The search produced 310 articles and the number rose to 350 after adding articles from other search engines and reference lists. Twenty papers were included that appropriately tackled the issue of the presence (but not of its pathophysiological role of neuroinflammation in bipolar disorder. Of these, 15 were postmortem and 5 were carried out in living humans. Most articles were consistent with the presence of neuroinflammation in bipolar disorder, but factors such as treatment may mask it. All studies were cross-sectional, preventing causality to be inferred. Thus, no inference can be currently made about the role of neuroinflammation in bipolar disorder, but a link is likely. The issue remains little investigated, despite an excess of reviews on this topic.

  3. Bipolar Disorder in Children

    Science.gov (United States)

    2014-01-01

    Although bipolar disorder historically was thought to only occur rarely in children and adolescents, there has been a significant increase in children and adolescents who are receiving this diagnosis more recently (Carlson, 2005). Nonetheless, the applicability of the current bipolar disorder diagnostic criteria for children, particularly preschool children, remains unclear, even though much work has been focused on this area. As a result, more work needs to be done to further the understanding of bipolar symptoms in children. It is hoped that this paper can assist psychologists and other health service providers in gleaning a snapshot of the literature in this area so that they can gain an understanding of the diagnostic criteria and other behaviors that may be relevant and be informed about potential approaches for assessment and treatment with children who meet bipolar disorder criteria. First, the history of bipolar symptoms and current diagnostic criteria will be discussed. Next, assessment strategies that may prove helpful for identifying bipolar disorder will be discussed. Then, treatments that may have relevance to children and their families will be discussed. Finally, conclusions regarding work with children who may have a bipolar disorder diagnosis will be offered. PMID:24800202

  4. [Prevention of bipolar disorders].

    Science.gov (United States)

    Leopold, K; Pfennig, A; Severus, E; Bauer, M

    2013-11-01

    In the past, preventive measures for psychoses have focused mainly on schizophrenic disorders. Bipolar disorders are often diagnosed and treated with a significant delay. The expansion of preventive measures for bipolar disorders aims at minimizing the substantial negative consequences associated with the disease. Some of the shared aspects of prevention in psychoses and bipolar disorders are that the first symptoms commonly appear during adolescence and early adulthood and that there is a symptomatic overlap between the disorders. To improve efforts to seek early help, public information about mental illness, low threshold services as well as cooperation between adult, child and adolescent psychiatry are needed for this target group. One differences is that psychotic symptoms play a minor role in bipolar disorders. Specific biological markers, such as disturbances of sleep and circadian rhythm and clinical characteristics, such as substance use and behavioral problems in childhood and youth supplement (subsyndromal) clinical symptoms in a multifactorial risk model. Besides severity and frequency of symptoms, specific periodic course patterns are crucial. Strategies of early intervention require a careful consideration of risks and benefits. Two aims should be distinguished: the improvement of current symptomatology and the prevention of conversion to bipolar disorder. Currently, studies evaluating risks and benefits of such interventions are first conducted. Expertise and resources for early recognition of psychoses and bipolar disorders should be pooled. Common standards are the basis for advancement and implementation of preventive strategies for bipolar disorders.

  5. Bifurcation analysis of parametrically excited bipolar disorder model

    Science.gov (United States)

    Nana, Laurent

    2009-02-01

    Bipolar II disorder is characterized by alternating hypomanic and major depressive episode. We model the periodic mood variations of a bipolar II patient with a negatively damped harmonic oscillator. The medications administrated to the patient are modeled via a forcing function that is capable of stabilizing the mood variations and of varying their amplitude. We analyze analytically, using perturbation method, the amplitude and stability of limit cycles and check this analysis with numerical simulations.

  6. Evaluation of a new rapid readout biological indicator for use in 132°C and 135°C vacuum-assisted steam sterilization cycles.

    Science.gov (United States)

    Schneider, Philip M

    2014-02-01

    Sterilization is a process that cannot be inspected or tested in a practical manner to assure that all microorganisms have been inactivated. The process must therefore be validated for all of the specific items processed or monitored on a per cycle basis. A new, faster rapid readout biological indicator (RRBI) has been developed for use in 132°C and 135°C vacuum-assisted steam sterilization cycles. The aim of this study was to evaluate the performance of this new 1-hour readout RRBI at 132°C in side-by-side testing with an existing 3-hour readout RRBI and also evaluate the performance of the new RRBI in 135°C cycles. Readout responses of 1 hour (fluorescent) and 48 hours and 7 days (growth) of the new RRBI were compared with 3-hour, 48-hour, and 7-day readouts of the 3-hour RRBI following exposures in 132°C cycles using a highly controlled test vessel, ie, a steam resistometer. Additional testing of the 1-hour RRBIs was also performed in 135°C cycles. The number and percentage of fluorescent-positive 1-hour RRBIs were virtually identical to those of the 3-hour RRBIs after 1 and 3 hours of incubation, respectively. Testing of the 1-hour RRBI in 135°C cycles paralleled the results of the testing at 132°C but with the expected shorter exposure times. The results of this study suggest that the 1-hour RRBI is equivalent to the 3-hour RRBI and would be suitable for use in monitoring dynamic air removal steam sterilization cycles at both 132°C and 135°C per recommended practice guidelines. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  7. Rapid changes in the seasonal sea level cycle along the US Gulf coast from the late 20th century

    Science.gov (United States)

    Wahl, Thomas; Calafat, Francisco M.; Luther, Mark E.

    2014-01-01

    Temporal variations of the seasonal sea level harmonics throughout the 20th and early 21st century along the United States Gulf coast are investigated. A significant amplification of the annual sea level cycle from the 1990s onward is found, with both lower winter and higher summer sea levels in the eastern Gulf. Ancillary data are used to build a set of multiple regression models to explore the mechanisms driving the decadal variability and recent increase in the annual cycle. The results suggest that changes in the air surface temperature toward warmer summers and colder winters and changes in mean sea level pressure explain most of the amplitude increase. The changes in the seasonal sea level cycle are shown to have almost doubled the risk of hurricane induced flooding associated with sea level rise since the 1990s for the eastern and north-eastern Gulf of Mexico coastlines.

  8. Duration of untreated bipolar disorder: missed opportunities on the long road to optimal treatment.

    Science.gov (United States)

    Drancourt, N; Etain, B; Lajnef, M; Henry, C; Raust, A; Cochet, B; Mathieu, F; Gard, S; Mbailara, K; Zanouy, L; Kahn, J P; Cohen, R F; Wajsbrot-Elgrabli, O; Leboyer, M; Scott, J; Bellivier, F

    2013-02-01

    Duration of untreated illness represents a potentially modifiable component of any diagnosis-treatment pathway. In bipolar disorder (BD), this concept has rarely been systematically defined or not been applied to large clinically representative samples. In a well-characterized sample of 501 patients with BD, we estimated the duration of untreated bipolar disorder (DUB: the interval between the first major mood episode and first treatment with a mood stabilizer). Associations between DUB and clinical onset and the temporal sequence of key clinical milestones were examined. The mean DUB was 9.6 years (SD 9.7; median 6). The median DUB for those with a hypomanic onset (14.5 years) exceeded that for depressive (13 years) and manic onset (8 years). Early onset BD cases have the longest DUB (P < 0.0001). An extended DUB was associated with more mood episodes (P < 0.0001), more suicidal behaviour (P = 0.0003) and a trend towards greater lifetime mood instability (e.g. rapid cycling, possible antidepressant-induced mania). Duration of untreated bipolar disorder (DUB) will only be significantly reduced by more aggressive case finding strategies. Reliable diagnosis (especially for BD-II) and/or instigation of recommended treatments is currently delayed by insufficient awareness of the early, polymorphous presentations of BD, lack of systematic screening and/or failure to follow established guidelines. © 2012 John Wiley & Sons A/S.

  9. Higher Baseline Proinflammatory Cytokines Mark Poor Antidepressant Response in Bipolar Disorder.

    Science.gov (United States)

    Benedetti, Francesco; Poletti, Sara; Hoogenboezem, Thomas A; Locatelli, Clara; de Wit, Harm; Wijkhuijs, Annemarie J M; Colombo, Cristina; Drexhage, Hemmo A

    The clinical relevance of raised levels of circulating cytokines in bipolar disorder is still unclear. Cytokines influence neurotransmitters, neuroplasticity, and white matter integrity. An inconsistent literature suggests that higher cytokine levels could hamper antidepressant response. Total sleep deprivation (TSD) and light therapy (LT) prompt a rapid antidepressant response and can provide a model treatment to study predictors of response. We studied at baseline 15 immune-regulating compounds in 37 consecutively admitted inpatients with a major depressive episode in the course of bipolar disorder (DSM-5 criteria) and in 24 controls. Thirty-one patients (84%) had a lifetime history of drug resistance. Patients were administered 3 TSD + LT cycles in 1 week (study period: 2010-2012). Data were analyzed with age- and false-discovery-rate-corrected analysis of variance and were tested as predictors in a regressive model. Twenty-three patients (62%) responded to treatment (Inventory of Depressive Symptomatology IDS-C score cytokines (Q² = 0.15), and a high factor score significantly predicted worse response (b = -0.692; W = 4.34, P = .037). A higher body mass index correlated with higher cytokines (r = 0.430, P = .010), indirectly hampering response (b = -0.0192, P = .013). Proinflammatory compounds reflecting an M1-like proinflammatory state of monocytes/macrophages are associated with a poor response to antidepressant TSD + LT treatment in bipolar depression.

  10. Hemlock declines rapidly with hemlock woolly adelgid infestation: impacts on the carbon cycle of the Southern Appalachian forests

    Science.gov (United States)

    April E. Nuckolls; Nina Wurzburger; Chelcy R. Ford; Ronald L. Hendrick; James M. Vose; Brian D. Kloeppel

    2008-01-01

    The recent infestation of southern Appalachian eastern hemlock stands by hemlock woolly adelgid (HWA) is expected to have dramatic and lasting effects on forest structure and function. We studied the short-term changes to the carbon cycle in a mixed stand of hemlock and hardwoods, where hemlock was declining due to either girdling or HWA infestation. We expected that...

  11. Bipolar Disorder (For Teens)

    Science.gov (United States)

    ... the juvenile justice system, abusing drugs, or committing suicide. Because children and teens with bipolar disorder do not usually show the ... September 2015 previous 1 • 2 • 3 • 4 ... Contact Us Print Resources Send to a Friend ...

  12. Prestige and bipolarity.

    Science.gov (United States)

    Le Bas, James; Castle, David; Newton, Richard; O'Loughlin, Denis

    2013-10-01

    To explore aspects of prestige in the bipolar disorders. Conceptualisation around bipolar spectrum disorders is in its infancy, in particular with relation to their neurobiological and evolutionary underpinnings. While research has privileged proximate causation, a separate, nascent dialogue in relation to the 'aboutness' of affective syndromes exists. Arguably, affective disorders can be considered in relation to the social group phenomena of self-esteem and prestige. A conceptualisation of Panksepp's PLAY and Thayer's energetic arousal systems combined- Hedonic Energetic Social Engagement- can be invoked as a mechanism for bipolarity. This has been acted upon by prestige competition to create a selection pressure for prestige. In this model, bipolar spectrum conditions evolved as a by-product of this process.

  13. Cytokines in bipolar disorder

    DEFF Research Database (Denmark)

    Munkholm, Klaus; Vinberg, Maj; Vedel Kessing, Lars

    2012-01-01

    BACKGROUND: Current research and hypothesis regarding the pathophysiology of bipolar disorder suggests the involvement of immune system dysfunction that is possibly related to disease activity. Our objective was to systematically review evidence of cytokine alterations in bipolar disorder according...... to affective state. METHODS: We conducted a systemtic review of studies measuring endogenous cytokine concentrations in patients with bipolar disorder and a meta-analysis, reporting results according to the PRISMA statement. RESULTS: Thirteen studies were included, comprising 556 bipolar disorder patients...... and 767 healthy controls, evaluating 15 different cytokines-, cytokine receptors- or cytokine antagonists. The levels of tumor necrosis factor-α (TNF-α), the soluble tumor necrosis factor receptor type 1 (sTNF-R1) and the soluble inlerleukin-2 receptor (sIL-2R) were elevated in manic patients compared...

  14. Bipolar Disorder - Multiple Languages

    Science.gov (United States)

    ... Supplements Videos & Tools You Are Here: Home → Multiple Languages → All Health Topics → Bipolar Disorder URL of this page: https://medlineplus.gov/languages/bipolardisorder.html Other topics A-Z Expand Section ...

  15. Predictors and outcomes of somatization in bipolar I disorder: A latent class mixture modeling approach.

    Science.gov (United States)

    Edgcomb, Juliet Beni; Kerner, Berit

    2017-11-16

    Mood disorders are often associated with somatic symptoms. The role of somatic symptoms on disease progression in unipolar depression is substantially better characterized than that role in bipolar disorder. Moreover, the contribution of comorbid anxiety disorders and medical illness is not well understood. We investigated 527 patients with bipolar I disorder clustered within 102 families using a latent class approach. Predictors were added stepwise into the model. Anxiety and commonly associated medical illnesses were added as covariates. The rate of somatic symptoms in this sample was 73% (mean 1.7 symptoms), and 27.3% had a comorbid anxiety disorder. A two-class model, with a subgroup at high-risk for somatization, gave the best fit to the data. Multilevel mixture modeling accounted for family clusters. Somatic symptoms were independently associated with disease severity, defined as earlier age of first seeking psychiatric help (x = 21.7 vs x = 24.7, p = 0.005) and first psychiatric hospitalization (x = 25.7 vs x = 28.2, p = 0.03), greater probability of attempting suicide (x = 0.41 vs x = 0.32, p = 0.047), and rapid-cycling disease course (x = 0.57 vs x = 0.36, p somatic symptoms were more likely to be hospitalized for severe mania (x = 0.63 vs x = 0.51; p = 0.013), but did not significantly differ in hospitalization for severe depression. The study is correlational. Information on pharmacologic interventions and comorbid diseases was limited. Somatic symptoms in bipolar disorder could be an independent indicator for disease severity, suicidality, and rapid-cycling disease course. In severe mental illness, somatic and psychological symptoms must be jointly addressed. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. The Role of the Silicon Cycle in the Eocene-Oligocene Transition: Rapid Rise in Diatom-δ30Si

    Science.gov (United States)

    Egan, K. E.; Rickaby, R. E.; Leng, M. J.; Halliday, A. N.

    2011-12-01

    The Eocene-Oligocene (E-O) boundary represents a time of major climatic change which heralded the descent of Earth's climate from earlier greenhouse conditions into today's icehouse world. Decline of atmospheric CO2 levels, development of major ice sheets on Antarctica and initiation of the Antarctic Circumpolar Current around 34Ma ago dramatically changed the state of the atmosphere, cryosphere and hydrosphere: Major isotopic excursions are seen in both marine oxygen and carbon cycles, and yet the mechanisms behind this transition are still not fully understood. Unravelling the causes of such a significant climatic shift is essential to furthering our grasp on the mechanisms that control climate. The silicon isotope composition (δ30Si) preserved in diatom opal provides a window to the E-O Silicon cycle. The Silicon cycle is a key player in controlling atmospheric CO2 levels for two reasons. Firstly, weathering of silicate minerals acts to draw down CO2 into the ocean and ultimately sediments. Secondly, carbon export from the surface ocean by diatoms, siliceous walled phytoplankton, facilitates carbon transport to a deep ocean sink. We present a long term record of diatom-δ30Si record covering 37Ma to 25Ma, with E-O boundary targeted higher resolution (sponge spicule-δ30Si of ~2% seen by De La Rocha (2003) in sediments from the Maud Rise (ODP site 689). Taken together, these records demonstrate that changes are occurring in both the surface and deep waters of the Southern Ocean across this boundary. We will discuss the implications this has for silicon cycling across the E-O transition, in terms of variation in both weathering and diatom productivity, and the impact that this may have had on global climate.

  17. Rapid Solid-Phase Immunoassay for Detection of Methicillin-Resistant Staphylococcus aureus Using Cycling Probe Technology

    OpenAIRE

    Fong, Whalley K.; Modrusan, Zora; McNevin, John P.; Marostenmaki, Johanna; Zin, Ben; Bekkaoui, Faouzi

    2000-01-01

    A Cycling Probe Technology (CPT) assay with a lateral-flow device (strip) was developed for the detection of the mecA gene from methicillin-resistant Staphylococcus aureus (MRSA) cultures. The assay uses a mecA probe (DNA-RNA-DNA) labeled with fluorescein at the 5′ terminus and biotin at the 3′ terminus. The CPT reaction occurs at a constant temperature, which allows the probe to anneal to the target DNA. RNase H cuts the RNA portion of the probe, allowing the cleaved fragments to dissociate ...

  18. Adjunctive Bright Light Therapy for Bipolar Depression: A Randomized Double-Blind Placebo-Controlled Trial.

    Science.gov (United States)

    Sit, Dorothy K; McGowan, James; Wiltrout, Christopher; Diler, Rasim Somer; Dills, John Jesse; Luther, James; Yang, Amy; Ciolino, Jody D; Seltman, Howard; Wisniewski, Stephen R; Terman, Michael; Wisner, Katherine L

    2018-02-01

    Patients with bipolar disorder have recurrent major depression, residual mood symptoms, and limited treatment options. Building on promising pilot data, the authors conducted a 6-week randomized double-blind placebo-controlled trial to investigate the efficacy of adjunctive bright light therapy at midday for bipolar depression. The aims were to determine remission rate, depression symptom level, and rate of mood polarity switch, as well as to explore sleep quality. The study enrolled depressed adults with bipolar I or II disorder who were receiving stable dosages of antimanic medication (excluding patients with hypomania or mania, mixed symptoms, or rapid cycling). Patients were randomly assigned to treatment with either 7,000-lux bright white light or 50-lux dim red placebo light (N=23 for each group). Symptoms were assessed weekly with the Structured Interview Guide for the Hamilton Depression Scale With Atypical Depression Supplement (SIGH-ADS), the Mania Rating Scale, and the Pittsburgh Sleep Quality Index. Remission was defined as having a SIGH-ADS score of 8 or less. At baseline, both groups had moderate depression and no hypomanic or manic symptoms. Compared with the placebo light group, the group treated with bright white light experienced a significantly higher remission rate (68.2% compared with 22.2%; adjusted odds ratio=12.6) at weeks 4-6 and significantly lower depression scores (9.2 [SD=6.6] compared with 14.9 [SD=9.2]; adjusted β=-5.91) at the endpoint visit. No mood polarity switches were observed. Sleep quality improved in both groups and did not differ significantly between them. The data from this study provide robust evidence that supports the efficacy of midday bright light therapy for bipolar depression.

  19. Exponential state transition dynamics in the rest-activity architecture of patients with bipolar disorder.

    Science.gov (United States)

    Ortiz, Abigail; Bradler, Kamil; Radu, Luiza; Alda, Martin; Rusak, Benjamin

    2016-03-01

    Our goal was to model the temporal dynamics of sleep-wake transitions, represented by transitions between rest and activity obtained from actigraphic data, in patients with bipolar disorder using a probabilistic state transition approach. We collected actigraphic data for 14 days from 20 euthymic patients with bipolar disorder, who had been characterized clinically, demographically, and with respect to their circadian preferences (chronotype). We processed each activity record to generate a series of transitions in both directions between the states of rest (R) and activity (A) and plotted the estimated transition probabilities (pRA and pAR). Each 24-hour period was also divided into a rest phase consisting of the eight consecutive least active hours in each day and an active phase consisting of the 16 consecutive most active hours in each day. We then calculated separate transition probabilities for each of these phases for each participant. We subsequently modeled the rest phase data to find the best fit for rest-activity transitions using maximum likelihood estimation. We also examined the association of transition probabilities with clinical and demographic variables. The best-fit model for rest-activity transitions during the rest phase was a mixture (bimodal) of exponential functions. Of those patients with rapid cycling, 75% had an evening-type chronotype. Patients with bipolar II disorder taking antidepressants had a lower probability of transitioning back to rest than those not on antidepressants [mean ± SD = 0.050 ± 0.006 versus 0.141 ± 0.058, F(1,15) = 3.40, p bipolar disorder can be accounted for by a mixture (bimodal) of exponential functions. Patients taking antidepressants had a reduced probability of sustaining and returning to sleep. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Bipolar Affective Disorder and Migraine

    Directory of Open Access Journals (Sweden)

    Birk Engmann

    2012-01-01

    Full Text Available This paper consists of a case history and an overview of the relationship, aetiology, and treatment of comorbid bipolar disorder migraine patients. A MEDLINE literature search was used. Terms for the search were bipolar disorder bipolar depression, mania, migraine, mood stabilizer. Bipolar disorder and migraine cooccur at a relatively high rate. Bipolar II patients seem to have a higher risk of comorbid migraine than bipolar I patients have. The literature on the common roots of migraine and bipolar disorder, including both genetic and neuropathological approaches, is broadly discussed. Moreover, bipolar disorder and migraine are often combined with a variety of other affective disorders, and, furthermore, behavioural factors also play a role in the origin and course of the diseases. Approach to treatment options is also difficult. Several papers point out possible remedies, for example, valproate, topiramate, which acts on both diseases, but no first-choice treatments have been agreed upon yet.

  1. Depression and Bipolar Support Alliance

    Science.gov (United States)

    Depression and Bipolar Support Alliance Crisis Hotline Information Coping with a Crisis Suicide Prevention Information Psychiatric Hospitalization ... sign-up Education info, training, events Mood Disorders Depression Bipolar Disorder Anxiety Screening Center Co-occurring Illnesses/ ...

  2. Bipolar Neutrosophic Soft Expert Sets

    OpenAIRE

    Şahin, Mehmet; Deli, İrfan; Uluçay, Vakkas

    2016-01-01

    In this paper, we introduce concept of bipolar neutrosophic soft expert set and its some operations. Also, we propose score, certainty and accuracy functions to compare the bipolar neutrosophic soft expert sets. We give examples for these concepts. 

  3. Rapid phase adjustment of melatonin and core body temperature rhythms following a 6-h advance of the light/dark cycle in the horse

    Directory of Open Access Journals (Sweden)

    Kennedy Erin L

    2007-08-01

    Full Text Available Abstract Background Rapid displacement across multiple time zones results in a conflict between the new cycle of light and dark and the previously entrained program of the internal circadian clock, a phenomenon known as jet lag. In humans, jet lag is often characterized by malaise, appetite loss, fatigue, disturbed sleep and performance deficit, the consequences of which are of particular concern to athletes hoping to perform optimally at an international destination. As a species renowned for its capacity for athletic performance, the consequences of jet lag are also relevant for the horse. However, the duration and severity of jet lag related circadian disruption is presently unknown in this species. We investigated the rates of re-entrainment of serum melatonin and core body temperature (BT rhythms following an abrupt 6-h phase advance of the LD cycle in the horse. Methods Six healthy, 2 yr old mares entrained to a 12 h light/12 h dark (LD 12:12 natural photoperiod were housed in a light-proofed barn under a lighting schedule that mimicked the external LD cycle. Following baseline sampling on Day 0, an advance shift of the LD cycle was accomplished by ending the subsequent dark period 6 h early. Blood sampling for serum melatonin analysis and BT readings were taken at 3-h intervals for 24 h on alternate days for 11 days. Disturbances to the subsequent melatonin and BT 24-h rhythms were assessed using repeated measures ANOVA and analysis of Cosine curve fitting parameters. Results We demonstrate that the equine melatonin rhythm re-entrains rapidly to a 6-h phase advance of an LD12:12 photocycle. The phase shift in melatonin was fully complete on the first day of the new schedule and rhythm phase and waveform were stable thereafter. In comparison, the advance in the BT rhythm was achieved by the third day, however BT rhythm waveform, especially its mesor, was altered for many days following the LD shift. Conclusion Aside from the temperature

  4. Rapid Ammonia Gas Transport Accounts for Futile Transmembrane Cycling under NH3/NH4+ Toxicity in Plant Roots1[C][W

    Science.gov (United States)

    Coskun, Devrim; Britto, Dev T.; Li, Mingyuan; Becker, Alexander; Kronzucker, Herbert J.

    2013-01-01

    Futile transmembrane NH3/NH4+ cycling in plant root cells, characterized by extremely rapid fluxes and high efflux to influx ratios, has been successfully linked to NH3/NH4+ toxicity. Surprisingly, the fundamental question of which species of the conjugate pair (NH3 or NH4+) participates in such fluxes is unresolved. Using flux analyses with the short-lived radioisotope 13N and electrophysiological, respiratory, and histochemical measurements, we show that futile cycling in roots of barley (Hordeum vulgare) seedlings is predominately of the gaseous NH3 species, rather than the NH4+ ion. Influx of 13NH3/13NH4+, which exceeded 200 µmol g–1 h–1, was not commensurate with membrane depolarization or increases in root respiration, suggesting electroneutral NH3 transport. Influx followed Michaelis-Menten kinetics for NH3 (but not NH4+), as a function of external concentration (Km = 152 µm, Vmax = 205 µmol g–1 h–1). Efflux of 13NH3/13NH4+ responded with a nearly identical Km. Pharmacological characterization of influx and efflux suggests mediation by aquaporins. Our study fundamentally revises the futile-cycling model by demonstrating that NH3 is the major permeating species across both plasmalemma and tonoplast of root cells under toxicity conditions. PMID:24134887

  5. FLOWERING LOCUS C EXPRESSOR family proteins regulate FLOWERING LOCUS C expression in both winter-annual and rapid-cycling Arabidopsis.

    Science.gov (United States)

    Ding, Lei; Kim, Sang Yeol; Michaels, Scott D

    2013-09-01

    Many naturally occurring Arabidopsis (Arabidopsis thaliana) are very late flowering, unless flowering is promoted by a prolonged period of cold (e.g. winter) known as vernalization. In these winter-annual strains, flowering prior to winter is blocked by the synergistic interaction of FRIGIDA (FRI) and FLOWERING LOCUS C (FLC). FLC acts as a strong floral inhibitor, and FRI is required for high levels of FLC expression. Vernalization, in turn, leads to an epigenetic down-regulation of FLC expression. Most rapid-cycling Arabidopsis carry loss-of-function mutations in FRI, leading to low levels of FLC and rapid flowering in the absence of vernalization. Recent work has shown that FRI acts as a scaffolding protein for the assembly of a FRI complex (FRI-C) that includes both general transcription and chromatin-modifying factors, as well as FRI-specific components such as FRI-LIKE1, FRI ESSENTIAL1 (FES1), SUPPRESSOR OF FRI4 (SUF4), and FLC EXPRESSOR (FLX). Here, we show that FLX-LIKE4 (FLX4) is a novel component of the FRI-C and is essential for the activation of FLC by FRI. Both FLX and FLX4 contain leucine zipper domains that facilitate interaction with FRI. In addition, FLX and FLX4 interact with each other and show synergistic transcription activation activity. Interestingly, we show that FLX, FLX4, FES1, and SUF4 are required for basal levels of FLC expression in the absence of FRI. Thus, components of the FRI-C play a role in the regulation of FLC expression in both FRI-containing winter annuals, as well as fri-null rapid-cycling strains.

  6. Toward a complex system understanding of bipolar disorder: A chaotic model of abnormal circadian activity rhythms in euthymic bipolar disorder.

    Science.gov (United States)

    Hadaeghi, Fatemeh; Hashemi Golpayegani, Mohammad Reza; Jafari, Sajad; Murray, Greg

    2016-08-01

    In the absence of a comprehensive neural model to explain the underlying mechanisms of disturbed circadian function in bipolar disorder, mathematical modeling is a helpful tool. Here, circadian activity as a response to exogenous daily cycles is proposed to be the product of interactions between neuronal networks in cortical (cognitive processing) and subcortical (pacemaker) areas of the brain. To investigate the dynamical aspects of the link between disturbed circadian activity rhythms and abnormalities of neurotransmitter functioning in frontal areas of the brain, we developed a novel mathematical model of a chaotic system which represents fluctuations in circadian activity in bipolar disorder as changes in the model's parameters. A novel map-based chaotic system was developed to capture disturbances in circadian activity across the two extreme mood states of bipolar disorder. The model uses chaos theory to characterize interplay between neurotransmitter functions and rhythm generation; it aims to illuminate key activity phenomenology in bipolar disorder, including prolonged sleep intervals, decreased total activity and attenuated amplitude of the diurnal activity rhythm. To test our new cortical-circadian mathematical model of bipolar disorder, we utilized previously collected locomotor activity data recorded from normal subjects and bipolar patients by wrist-worn actigraphs. All control parameters in the proposed model have an important role in replicating the different aspects of circadian activity rhythm generation in the brain. The model can successfully replicate deviations in sleep/wake time intervals corresponding to manic and depressive episodes of bipolar disorder, in which one of the excitatory or inhibitory pathways is abnormally dominant. Although neuroimaging research has strongly implicated a reciprocal interaction between cortical and subcortical regions as pathogenic in bipolar disorder, this is the first model to mathematically represent this

  7. Anticonvulsants in bipolar disorder.

    Science.gov (United States)

    Grunze, Heinz C R

    2010-04-01

    Anticonvulsant drugs are widely used in psychiatric indications. This includes alcohol and benzodiazepine withdrawal symptoms, panic and anxiety disorders, dementia, schizophrenia, and to some extent personality disorders. Besides pain syndromes, their main domain outside epilepsy, however, is bipolar disorder. Carbamazepine, valproate, and lamotrigine are meanwhile recognized mood stabilizers, but several other antiepileptic drugs have also been tried out with diverging or inconclusive results. Understanding the mechanisms of action and identifying similarities between anticonvulsants effective in bipolar disorder may also enhance our understanding of the underlying pathophysiology of the disorder.

  8. The International College of Neuropsychopharmacology (CINP) Treatment Guidelines for Bipolar Disorder in Adults (CINP-BD-2017), Part 4: Unmet Needs in the Treatment of Bipolar Disorder and Recommendations for Future Research

    Science.gov (United States)

    Vieta, Eduard; Young, Allan; Yatham, Lakshmi; Grunze, Heinz; Blier, Pierre; Moeller, Hans Jurgen; Kasper, Siegfried

    2017-01-01

    Abstract Background: The current fourth paper on the International College of Neuropsychopharmacology guidelines for the treatment of bipolar disorder reports on the unmet needs that became apparent after an extensive review of the literature and also serves as a conclusion to the project of the International College of Neuropsychopharmacology workgroup. Materials and Methods: The systematic review of the literature that was performed to develop the International College of Neuropsychopharmacology guidelines for bipolar disorder identified and classified a number of potential shortcomings. Results: Problems identified concerned the reliability and validity of the diagnosis of bipolar disorder and especially of bipolar depression. This, in turn, has profound consequences for early detection and correct treatment of the disorder. Another area that needs improvement is the unsatisfactory efficacy and effectiveness of therapeutic options, especially in special populations such as those with mixed features and rapid cycling course. Gender issues and adherence problems constitute an additional challenge. The literature suggests that while treatment providers are concerned more with treatment-related issues, patients and their caregivers worry more about issues pertaining to the availability of services and care, quality of life, and various types of burden. The workgroup identified additional unmet needs related to the current standard of research in bipolar disorder. These include the fragmentation of bipolar disorder into phases that are handled as being almost absolutely independent from each other, and thus the development of an overall therapeutic strategy on the basis of the existing evidence is very difficult. Trials are not always designed in a way that outcomes cover the most important aspects of bipolar disorder, and often the reporting of the results is biased and unsatisfactory. The data on combination treatments and high dosages are sparse, whereas they are

  9. Bipolar disorder: an update

    African Journals Online (AJOL)

    lifetime incidence), recurrent mood disorder, with strong genetic undertones, characterised ... impairment in occupational function.4 Depression is usually the predominant ... Bipolar disorder, characterised by alternating discrete episodes of (hypo)mania and depression, provides unique diagnostic and treatment challenges ...

  10. Is Cognitive Style Bipolar?

    Science.gov (United States)

    Schroeder, David H.

    This study assessed the bipolarity of cognitive style for 970 clients of the Johnson O'Connor Research Foundation, a vocational guidance service. The 462 male and 508 female examinees were aged 14 to 65 years, with a median age of 24 years. Three cognitive style tests were investigated: (1) the Kagan Matching Familiar Figures Test (KMFFT); (2) the…

  11. Using rapid-cycle quality improvement methodology to reduce feeding tubes in patients with advanced dementia: before and after study.

    Science.gov (United States)

    Monteleoni, Carol; Clark, Elizabeth

    2004-08-28

    Despite lack of evidence that enteral feeding tubes benefit patients with dementia, and often contrary to the wishes of patient and family, patients with dementia who have difficulty swallowing or reduced food intake often receive feeding tubes when hospitalised for an acute illness. We conducted a retrospective chart review of all patients receiving percutaneous endoscopic gastrostomy or jejunostomy tubes between March and September 2002. QI interventions including a palliative care consulting service and educational programmes were instituted. We conducted a second chart review for all patients receiving feeding tubes between March and September 2003. 652 bed urban acute care hospital. We measured the number of feeding tubes placed in patients with dementia, the number of feeding tubes placed in patients with dementia capable of taking food by mouth, and the number of feeding tubes placed in patients with dementia with an advance directive stating the wish to forgo artificial nutrition and hydration. Medical and allied health staff received educational programmes on end of life care and on feeding management of patients with dementia. A palliative care consulting team was established. After the interventions, the number of feeding tubes placed in all patients and in patients with dementia was greatly reduced. Multidisciplinary involvement, including participation by the administration, was essential to effect change in practice. The intensive focus on a particular issue and rapid change led to "culture shift" within the hospital community. The need to establish unified goals of care for each patient was highlighted. A growing body of research over the past decade has questioned the utility of placing feeding tubes (percutaneous endoscopic gastrostomy (PEG) or jejunostomy) in patients with advanced dementia. Studies have found no evidence that feeding tubes in this population prevent aspiration, prolong life, improve overall function, or reduce pressure sores

  12. Integration of BpMADS4 on various linkage groups improves the utilization of the rapid cycle breeding system in apple.

    Science.gov (United States)

    Weigl, Kathleen; Wenzel, Stephanie; Flachowsky, Henryk; Peil, Andreas; Hanke, Magda-Viola

    2015-02-01

    Rapid cycle breeding in apple is a new approach for the rapid introgression of agronomically relevant traits (e.g. disease resistances) from wild apple species into domestic apple cultivars (Malus × domestica Borkh.). This technique drastically shortens the long-lasting juvenile phase of apple. The utilization of early-flowering apple lines overexpressing the BpMADS4 gene of the European silver birch (Betula pendula Roth.) in hybridization resulted in one breeding cycle per year. Aiming for the selection of non-transgenic null segregants at the end of the breeding process, the flower-inducing transgene and the gene of interest (e.g. resistance gene) that will be introgressed by hybridization need to be located on different chromosomes. To improve the flexibility of the existing approach in apple, this study was focused on the development and characterization of eleven additional BpMADS4 overexpressing lines of four different apple cultivars. In nine lines, the flowering gene was mapped to different linkage groups. The differences in introgressed T-DNA sequences and plant genome deletions post-transformation highlighted the unique molecular character of each line. However, transgenic lines demonstrated no significant differences in flower organ development and pollen functionality compared with non-transgenic plants. Hybridization studies using pollen from the fire blight-resistant wild species accession Malus fusca MAL0045 and the apple scab-resistant cultivar 'Regia' indicated that BpMADS4 introgression had no significant effect on the breeding value of each transgenic line. © 2014 Society for Experimental Biology, Association of Applied Biologists and John Wiley & Sons Ltd.

  13. Using the Consolidated Framework for Implementation Research (CFIR) to produce actionable findings: a rapid-cycle evaluation approach to improving implementation.

    Science.gov (United States)

    Keith, Rosalind E; Crosson, Jesse C; O'Malley, Ann S; Cromp, DeAnn; Taylor, Erin Fries

    2017-02-10

    Much research does not address the practical needs of stakeholders responsible for introducing health care delivery interventions into organizations working to achieve better outcomes. In this article, we present an approach to using the Consolidated Framework for Implementation Research (CFIR) to guide systematic research that supports rapid-cycle evaluation of the implementation of health care delivery interventions and produces actionable evaluation findings intended to improve implementation in a timely manner. To present our approach, we describe a formative cross-case qualitative investigation of 21 primary care practices participating in the Comprehensive Primary Care (CPC) initiative, a multi-payer supported primary care practice transformation intervention led by the Centers for Medicare and Medicaid Services. Qualitative data include observational field notes and semi-structured interviews with primary care practice leadership, clinicians, and administrative and medical support staff. We use intervention-specific codes, and CFIR constructs to reduce and organize the data to support cross-case analysis of patterns of barriers and facilitators relating to different CPC components. Using the CFIR to guide data collection, coding, analysis, and reporting of findings supported a systematic, comprehensive, and timely understanding of barriers and facilitators to practice transformation. Our approach to using the CFIR produced actionable findings for improving implementation effectiveness during this initiative and for identifying improvements to implementation strategies for future practice transformation efforts. The CFIR is a useful tool for guiding rapid-cycle evaluation of the implementation of practice transformation initiatives. Using the approach described here, we systematically identified where adjustments and refinements to the intervention could be made in the second year of the 4-year intervention. We think the approach we describe has broad

  14. [Spouses and bipolar disorder].

    Science.gov (United States)

    Ellouze, F; Ayedi, S; Cherif, W; Ben Abla, T; M'rad, M F

    2011-02-01

    To assess the quality of life of a population of spouses of bipolar patients compared with a control population. We conducted a cross-sectional study which included two groups: a group of 30 spouses of patients followed for bipolar I disorder according to DSM IV criteria and a second group of 30 subjects from the general population. Both groups were matched by age, sex, marital status and socioeconomic level. This device was designed to limit the differences between the two groups solely those of the bipolar illness. Evaluating the quality of life was achieved using the quality of life scale: SF-36. This is a scale that has already been translated and validated in dialect Arabic. Regarding sociodemographic variables, the two study groups differed only for: recreation, friendly relations and the couple relationship that included more and better skills among the control group. In the categorical approach, the quality of life was impaired in 60% of spouses and 40% of controls with a statistically significant difference. The following standardized dimensions: mental health (D4), limitation due to mental health (D5), life and relationship with others (D6) and perceived health (D8) and mental component (CM) were significantly altered in patients' spouses compared to controls. We found significant differences between the two groups for: overall average score (51.1 vs. 68.2), mental health (D4), limitation due to mental health (D5), life and relationship with others (D6), perceived health (D8) and perceived health (D8) standards. The impairment of quality of life of bipolar patients' spouses is related to the extra responsibility, stress, financial problems and health problems, stigma, and loss of security of the person loved. Considering the consequences that the appearance of bipolar disorder on the patient's spouse may have, certain measures must be proposed to improve their quality of life. Copyright © 2010 L'Encéphale, Paris. Published by Elsevier Masson SAS. All

  15. ON BIPOLAR SINGLE VALUED NEUTROSOPHIC GRAPHS

    OpenAIRE

    Said Broumi; Mohamed Talea; Assia Bakali; Florentin Smarandache

    2016-01-01

    In this article, we combine the concept of bipolar neutrosophic set and graph theory. We introduce the notions of bipolar single valued neutrosophic graphs, strong bipolar single valued neutrosophic graphs, complete bipolar single valued neutrosophic graphs, regular bipolar single valued neutrosophic graphs and investigate some of their related properties. 

  16. On Bipolar Single Valued Neutrosophic Graphs

    OpenAIRE

    SAID BROUMI; MOHAMED TALEA; ASSIA BAKALI; FLORENTIN SMARANDACHE

    2016-01-01

    In this article, we combine the concept of bipolar neutrosophic set and graph theory. We introduce the notions of bipolar single valued neutrosophic graphs, strong bipolar single valued neutrosophic graphs, complete bipolar single valued neutrosophic graphs, regular bipolar single valued neutrosophic graphs and investigate some of their related properties. 

  17. Is age of onset associated with severity, prognosis, and clinical features in bipolar disorder? A meta-analytic review.

    Science.gov (United States)

    Joslyn, Cassandra; Hawes, David J; Hunt, Caroline; Mitchell, Philip B

    2016-08-01

    To identify clinical characteristics and adverse outcomes associated with an earlier age of onset of bipolar disorder. A comprehensive search yielded 15 empirical papers comparing clinical presentation and outcomes in individuals with bipolar disorder grouped according to age of onset (total N=7370). The following variables were examined to determine odds ratios (ORs) and 95% confidence intervals (CIs): presence of Axis I comorbidity, rapid cycling, psychotic symptoms, mixed episodes (DSM-IV), lifetime suicide attempts, lifetime alcohol and substance abuse, symptom severity, and treatment delay. Early age of onset was found to be associated with longer delay to treatment (Hedges' g=0.39, P=.001), greater severity of depression (Hedges' g=0.42, Pbipolar disorder is associated with factors that can negatively impact long-term outcomes such as increased comorbidity. However, no association was found between early onset and indicators of severity or treatment resistance such as psychotic symptoms. Clinical features found to have the strongest relationship with early age of onset were those potentially amenable to pharmacological and psychological treatment. Results highlight the importance of early identification and provide potential areas of focus for the development of early intervention in bipolar disorder. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. Early Intervention in Bipolar Disorder.

    Science.gov (United States)

    Vieta, Eduard; Salagre, Estela; Grande, Iria; Carvalho, André F; Fernandes, Brisa S; Berk, Michael; Birmaher, Boris; Tohen, Mauricio; Suppes, Trisha

    2018-01-24

    Bipolar disorder is a recurrent disorder that affects more than 1% of the world population and usually has its onset during youth. Its chronic course is associated with high rates of morbidity and mortality, making bipolar disorder one of the main causes of disability among young and working-age people. The implementation of early intervention strategies may help to change the outcome of the illness and avert potentially irreversible harm to patients with bipolar disorder, as early phases may be more responsive to treatment and may need less aggressive therapies. Early intervention in bipolar disorder is gaining momentum. Current evidence emerging from longitudinal studies indicates that parental early-onset bipolar disorder is the most consistent risk factor for bipolar disorder. Longitudinal studies also indicate that a full-blown manic episode is often preceded by a variety of prodromal symptoms, particularly subsyndromal manic symptoms, therefore supporting the existence of an at-risk state in bipolar disorder that could be targeted through early intervention. There are also identifiable risk factors that influence the course of bipolar disorder, some of them potentially modifiable. Valid biomarkers or diagnosis tools to help clinicians identify individuals at high risk of conversion to bipolar disorder are still lacking, although there are some promising early results. Pending more solid evidence on the best treatment strategy in early phases of bipolar disorder, physicians should carefully weigh the risks and benefits of each intervention. Further studies will provide the evidence needed to finish shaping the concept of early intervention.

  19. Pediatric bipolar disorder: validity, phenomenology, and recommendations for diagnosis

    Science.gov (United States)

    Youngstrom, Eric A; Birmaher, Boris; Findling, Robert L

    2013-01-01

    Objective To find, review, and critically evaluate evidence pertaining to the phenomenology of pediatric bipolar disorder and its validity as a diagnosis. Methods The present qualitative review summarizes and synthesizes available evidence about the phenomenology of bipolar disorder (BD) in youths, including description of the diagnostic sensitivity and specificity of symptoms, clarification about rates of cycling and mixed states, and discussion about chronic versus episodic presentations of mood dysregulation. The validity of the diagnosis of BD in youths is also evaluated based on traditional criteria including associated demographic characteristics, family environmental features, genetic bases, longitudinal studies of youths at risk of developing BD as well as youths already manifesting symptoms on the bipolar spectrum, treatment studies and pharmacologic dissection, neurobiological findings (including morphological and functional data), and other related laboratory findings. Additional sections review impairment and quality of life, personality and temperamental correlates, the clinical utility of a bipolar diagnosis in youths, and the dimensional versus categorical distinction as it applies to mood disorder in youths. Results A schema for diagnosis of BD in youths is developed, including a review of different operational definitions of `bipolar not otherwise specified.' Principal areas of disagreement appear to include the relative role of elated versus irritable mood in assessment, and also the limits of the extent of the bipolar spectrum – when do definitions become so broad that they are no longer describing `bipolar' cases? Conclusions In spite of these areas of disagreement, considerable evidence has amassed supporting the validity of the bipolar diagnosis in children and adolescents. PMID:18199237

  20. Hypersexuality and couple relationships in bipolar disorder: A review.

    Science.gov (United States)

    Kopeykina, Irina; Kim, Hae-Joon; Khatun, Tasnia; Boland, Jennifer; Haeri, Sophia; Cohen, Lisa J; Galynker, Igor I

    2016-05-01

    Although change in sexual behavior is recognized as an integral part of bipolar disorder, most of the relevant literature on sexual issues in patients with this illness concerns medication side effects and does not differentiate bipolar disorder from other serious mental disorders. Surprisingly, little has been published on mania-induced hypersexuality and the effects of mood cycling on couple relationships. In this review, we examine the extant literature on both of these subjects and propose a framework for future research. A search of PsycINFO and PubMed was conducted using keywords pertaining to bipolar disorder, hypersexuality and couple relationships. A total of 27 articles were selected for review. Despite lack of uniformity in diagnosis of bipolar disorder and no formal definition of hypersexuality, the literature points to an increased incidence of risky sexual behaviors in bipolar patients during manic episodes compared to patients with other psychiatric diagnoses. Further, it appears that bipolar patients are more similar to healthy controls than to other psychiatric patients when it comes to establishing and maintaining couple relationships. Nonetheless, the studies that examined sexuality in couples with one bipolar partner found decreased levels of sexual satisfaction associated with the diagnosis, varying levels of sexual interest across polarities, increased incidence of sexual dysfunction during depressive episodes, and disparate levels of satisfaction in general between patients and their partners. Due to changes in diagnostic criteria over time, there is a lack of uniformity in the definition of bipolar disorder across studies. Hypersexuality is not systematically defined and therefore the construct was not consistent across studies. Some of the older articles date back more than 30 years, making them subject to the biases of sexual and gender norms that have since become outdated. Finally, the heterogeneity of the samples, which include patients

  1. Bipolar Disorder in Children and Teens

    Science.gov (United States)

    ... is in crisis. What do I do? Share Bipolar Disorder in Children and Teens Download PDF Download ePub ... brochure will give you more information. What is bipolar disorder? Bipolar disorder is a serious brain illness. It ...

  2. Quetiapine monotherapy for bipolar depression.

    Science.gov (United States)

    Janicak, Philip G; Rado, Jeffrey T

    2011-07-01

    Depression, in the context of bipolar disorder, is more prevalent than hypomania or mania and accounts for most of the disability. Furthermore, the treatment of bipolar depression is more complicated than the treatment of unipolar major depression. Finally, the evidence base for pharmacotherapy of bipolar depression is much smaller than for unipolar depression or hypomania/mania. The article examines the mechanism of action and pharmacokinetics of quetiapine, its evidence base as a treatment for bipolar depression and related issues of safety and tolerability. In the context of bipolar disorder, quetiapine is the only monotherapy approved for the treatment of hypomania/mania, depression and as an adjunctive maintenance therapy. In addition to its antipsychotic properties, this broad mood stabilizing potential may uniquely benefit and simplify the management of some bipolar patients who can tolerate this agent. © 2011 Informa UK, Ltd.

  3. Bipolar disorder with seasonal pattern: clinical characteristics and gender influences

    Science.gov (United States)

    Geoffroy, Pierre Alexis; Bellivier, Frank; Scott, Jan; Boudebesse, Carole; Lajnef, Mohamed; Gard, Sébastien; Kahn, Jean-Pierre; Azorin, Jean-Michel; Henry, Chantal; Leboyer, Marion; Etain, Bruno

    2013-01-01

    Bipolar disorder (BD) has a multifactorial etiology with heterogeneous clinical presentations. Around 25% of BD patients may present with a depressive seasonal pattern (SP). However, there is limited scientific data on the prevalence of SP, its clinical manifestations and any gender influence. Four hundred and fifty-two BD I and II cases (62% female), recruited from three French university-affiliated psychiatric departments, were assessed for SP. Clinical, treatments and socio-demographic variables were obtained from structured interviews. One hundred and two (23%) cases met DSM-IV criteria for SP, with similar frequency according to gender. Multivariate analysis showed a significant association between SP and BD II (OR=1.99, p=0.01), lifetime history of rapid cycling (OR=2.05, p=0.02), eating disorders (OR=2.94, p=0.003) and total number of depressive episodes (OR=1.13, p=0.002). 71% of cases were correctly classified by this analysis. However, when stratifying the analyses by gender, SP was associated with BD II subtype (OR=2.89, p=0.017) and total number of depressive episodes (OR=1.21, p=0.0018) in males but with rapid cycling (OR=3.02, p=0.0027) and eating disorders (OR=2.60, p=0.016) in females. This is the first study to identify different associations between SP and clinical characteristics of BD according to gender. We suggest that SP represents a potentially important specifier of BD. Our findings indicate that seasonality may reflect increased severity or complexity of disorder. PMID:23931033

  4. Bipolar disorder with seasonal pattern: clinical characteristics and gender influences.

    Science.gov (United States)

    Geoffroy, Pierre Alexis; Bellivier, Frank; Scott, Jan; Boudebesse, Carole; Lajnef, Mohamed; Gard, Sébastien; Kahn, Jean-Pierre; Azorin, Jean-Michel; Henry, Chantal; Leboyer, Marion; Etain, Bruno

    2013-11-01

    Bipolar disorder (BD) has a multifactorial etiology with heterogeneous clinical presentations. Around 25% of BD patients may present with a depressive seasonal pattern (SP). However, there are limited scientific data on the prevalence of SP, its clinical manifestations, and any gender influence. Four hundred and fifty-two BD I and II cases (62% female), recruited from three French university-affiliated psychiatric departments, were assessed for SP. Clinical, treatment, and sociodemographic variables were obtained from structured interviews. One hundred and two (23%) cases met DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) criteria for SP, with similar frequency according to gender. Multivariate analysis showed a significant association between SP and BD II (odds ratio [OR] = 1.99, p = 0.01), lifetime history of rapid cycling (OR = 2.05, p = 0.02), eating disorders (OR = 2.94, p = 0.003), and total number of depressive episodes (OR = 1.13, p = 0.002). Seventy-one percent of cases were correctly classified by this analysis. However, when stratifying the analyses by gender, SP was associated with BD II subtype (OR = 2.89, p = 0.017) and total number of depressive episodes (OR = 1.21, p = 0.0018) in males but with rapid cycling (OR = 3.02, p = 0.0027) and eating disorders (OR = 2.60, p = 0.016) in females. This is the first study to identify different associations between SP and clinical characteristics of BD according to gender. The authors suggest that SP represents a potentially important specifier of BD. These findings indicate that seasonality may reflect increased severity or complexity of disorder.

  5. Historical Underpinnings of Bipolar Disorder Diagnostic Criteria

    Directory of Open Access Journals (Sweden)

    Brittany L. Mason

    2016-07-01

    Full Text Available Mood is the changing expression of emotion and can be described as a spectrum. The outermost ends of this spectrum highlight two states, the lowest low, melancholia, and the highest high, mania. These mood extremes have been documented repeatedly in human history, being first systematically described by Hippocrates. Nineteenth century contemporaries Falret and Baillarger described two forms of an extreme mood disorder, with the validity and accuracy of both debated. Regardless, the concept of a cycling mood disease was accepted before the end of the 19th century. Kraepelin then described “manic depressive insanity” and presented his description of a full spectrum of mood dysfunction which could be exhibited through single episodes of mania or depression or a complement of many episodes of each. It was this concept which was incorporated into the first DSM and carried out until DSM-III, in which the description of episodic mood dysfunction was used to build a diagnosis of bipolar disorder. Criticism of this approach is explored through discussion of the bipolar spectrum concept and some recent examinations of the clinical validity of these DSM diagnoses are presented. The concept of bipolar disorder in children is also explored.

  6. Historical Underpinnings of Bipolar Disorder Diagnostic Criteria

    Science.gov (United States)

    Mason, Brittany L.; Brown, E. Sherwood; Croarkin, Paul E.

    2016-01-01

    Mood is the changing expression of emotion and can be described as a spectrum. The outermost ends of this spectrum highlight two states, the lowest low, melancholia, and the highest high, mania. These mood extremes have been documented repeatedly in human history, being first systematically described by Hippocrates. Nineteenth century contemporaries Falret and Baillarger described two forms of an extreme mood disorder, with the validity and accuracy of both debated. Regardless, the concept of a cycling mood disease was accepted before the end of the 19th century. Kraepelin then described “manic depressive insanity” and presented his description of a full spectrum of mood dysfunction which could be exhibited through single episodes of mania or depression or a complement of many episodes of each. It was this concept which was incorporated into the first DSM and carried out until DSM-III, in which the description of episodic mood dysfunction was used to build a diagnosis of bipolar disorder. Criticism of this approach is explored through discussion of the bipolar spectrum concept and some recent examinations of the clinical validity of these DSM diagnoses are presented. The concept of bipolar disorder in children is also explored. PMID:27429010

  7. Bipolar Disorder and Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Sermin Kesebir

    2010-04-01

    Full Text Available Comorbid endocrine and cardiovascular situations with bipolar disorder usually result from the bipolar disorder itself or as a consequence of its treatment. With habits and lifestyle, genetic tendency and side effects, this situation is becoming more striking. Subpopulations of bipolar disorders patients should be considered at high risk for diabetes mellitus. The prevalence of diabetes mellitus in bipolar disorder may be three times greater than in the general population. Comorbidity of diabetes causes a pathophysiological overlapping in the neurobiological webs of bipolar cases. Signal mechanisms of glycocorticoid/insulin and immunoinflammatory effector systems are junction points that point out the pathophysiology between bipolar disorder and general medical cases susceptible to stress. Glycogen synthetase kinase (GSK-3 is a serine/treonine kinase and inhibits the transport of glucose stimulated by insulin. It is affected in diabetes, cancer, inflammation, Alzheimer disease and bipolar disorder. Hypoglycemic effect of lithium occurs via inhibiting glycogen synthetase kinase. When comorbid with diabetes, the other disease -for example bipolar disorder, especially during its acute manic episodes-, causes a serious situation that presents its influences for a lifetime. Choosing pharmacological treatment and treatment adherence are another important interrelated areas. The aim of this article is to discuss and review the etiological, clinical and therapeutic properties of diabetes mellitus and bipolar disorder comorbidity.

  8. [Creativity and bipolar disorder].

    Science.gov (United States)

    Maçkalı, Zeynep; Gülöksüz, Sinan; Oral, Timuçin

    2014-01-01

    The relationship between creativity and bipolar disorder has been an intriguing topic since ancient times. Early studies focused on describing characteristics of creative people. From the last quarter of the twentieth century, researchers began to focus on the relationship between mood disorders and creativity. Initially, the studies were based on biographical texts and the obtained results indicated a relationship between these two concepts. The limitations of the retrospective studies led the researchers to develop systematic investigations into this area. The systematic studies that have focused on artistic creativity have examined both the prevalence of mood disorders and the creative process. In addition, a group of researchers addressed the relationship in terms of affective temperaments. Through the end of the 90's, the scope of creativity was widened and the notion of everyday creativity was proposed. The emergence of this notion led researchers to investigate the associations of the creative process in ordinary (non-artist) individuals. In this review, the descriptions of creativity and creative process are mentioned. Also, the creative process is addressed with regards to bipolar disorder. Then, the relationship between creativity and bipolar disorder are evaluated in terms of aforementioned studies (biographical, systematic, psychobiographical, affective temperaments). In addition, a new model, the "Shared Vulnerability Model" which was developed to explain the relationship between creativity and psychopathology is introduced. Finally, the methodological limitations and the suggestions for resolving these limitations are included.

  9. Bipolar-value fuzzy soft lie subalgebras

    Science.gov (United States)

    Zhang, Xiong-wei

    2017-09-01

    In this paper, the notions of bipolar-value fuzzy soft Lie subalgebras are given, some of their properties are studied. Furthermore, we shall define the definition of bipolar-value fuzzy soft homomorphism of bipolar-value fuzzy soft Lie subalgebras and show that the theorem of bipolar-value fuzzy soft homomorphic pre-image of bipolar-value fuzzy soft Lie subalgebra, we shall give a counterexample which the image of a bipolar-value fuzzy soft Lie subalgebra under bipolar-value fuzzy soft homomorphism needs not be bipolar-value fuzzy soft Lie subalgebra.

  10. Bipolar soft connected, bipolar soft disconnected and bipolar soft compact spaces

    OpenAIRE

    Muhammad Shabir; Ayreena Bakhtawar

    2017-01-01

    Bipolar soft topological spaces are mathematical expressions to estimate interpretation of data frameworks. Bipolar soft theory considers the core features of data granules. Bipolarity is important to distinguish between positive information which is guaranteed to be possible and negative information which is forbidden or surely false. Connectedness and compactness are the most important fundamental topological properties. These properties highlight the main features of topological s...

  11. Solar Cycle 25: Another Moderate Cycle?

    Science.gov (United States)

    Cameron, R. H.; Jiang, J.; Schüssler, M.

    2016-06-01

    Surface flux transport simulations for the descending phase of Cycle 24 using random sources (emerging bipolar magnetic regions) with empirically determined scatter of their properties provide a prediction of the axial dipole moment during the upcoming activity minimum together with a realistic uncertainty range. The expectation value for the dipole moment around 2020 (2.5 ± 1.1 G) is comparable to that observed at the end of Cycle 23 (about 2 G). The empirical correlation between the dipole moment during solar minimum and the strength of the subsequent cycle thus suggests that Cycle 25 will be of moderate amplitude, not much higher than that of the current cycle. However, the intrinsic uncertainty of such predictions resulting from the random scatter of the source properties is considerable and fundamentally limits the reliability with which such predictions can be made before activity minimum is reached.

  12. A double-blind placebo-controlled study of lamotrigine monotherapy in outpatients with bipolar I depression. Lamictal 602 Study Group.

    Science.gov (United States)

    Calabrese, J R; Bowden, C L; Sachs, G S; Ascher, J A; Monaghan, E; Rudd, G D

    1999-02-01

    More treatment options for bipolar depression are needed. Currently available antidepressants may increase the risk of mania and rapid cycling, and mood stabilizers appear to be less effective in treating depression than mania. Preliminary data suggest that lamotrigine, an established antiepileptic drug, may be effective for both the depression and mania associated with bipolar disorder. This is the first controlled multicenter study evaluating lamotrigine monotherapy in the treatment of bipolar I depression. Outpatients with bipolar I disorder experiencing a major depressive episode (DSM-IV, N = 195) received lamotrigine (50 or 200 mg/day) or placebo as monotherapy for 7 weeks. Psychiatric evaluations, including the Hamilton Rating Scale for Depression (HAM-D), the Montgomery-Asberg Depression Rating Scale (MADRS), Mania Rating Scale, and the Clinical Global Impressions scale for Severity (CGI-S) and Improvement (CGI-I) were completed at each weekly visit. Lamotrigine 200 mg/day demonstrated significant antidepressant efficacy on the 17-item HAM-D, HAM-D Item 1, MADRS, CGI-S, and CGI-I compared with placebo. Improvements were seen as early as week 3. Lamotrigine 50 mg/day also demonstrated efficacy compared with placebo on several measures. The proportions of patients exhibiting a response on CGI-I were 51%, 41%, and 26% for lamotrigine 200 mg/day, lamotrigine 50 mg/day, and placebo groups, respectively. Adverse events and other safety results were similar across treatment groups, except for a higher rate of headache in the lamotrigine groups. Lamotrigine monotherapy is an effective and well-tolerated treatment for bipolar depression.

  13. Beam loss reduction by injection painting in the 3-GeV rapid cycling synchrotron of the Japan Proton Accelerator Research Complex

    Directory of Open Access Journals (Sweden)

    H. Hotchi

    2012-04-01

    Full Text Available The 3-GeV rapid cycling synchrotron (RCS of the Japan Proton Accelerator Research Complex was commissioned in October 2007. Via the initial beam tuning and a series of underlying beam studies with low-intensity beams, since December 2009, we have intermittently been performing beam tuning experiments with higher-intensity beams including the injection painting technique. By optimizing the injection painting parameters, we have successfully achieved a 420 kW-equivalent output intensity at a low-level intensity loss of less than 1%. Also the corresponding numerical simulation well reproduced the observed painting parameter dependence on the beam loss, and captured a characteristic behavior of the high-intensity beam in the injection painting process. In this paper, we present the experimental results obtained in the course of the RCS beam power ramp-up, especially on the beam loss reduction achieved by employing the injection painting, together with the numerical simulation results.

  14. The International College of Neuro-Psychopharmacology (CINP) Treatment Guidelines for Bipolar Disorder in Adults (CINP-BD-2017), Part 2: Review, Grading of the Evidence, and a Precise Algorithm

    Science.gov (United States)

    Yatham, Lakshmi; Grunze, Heinz; Vieta, Eduard; Young, Allan; Blier, Pierre; Kasper, Siegfried; Moeller, Hans Jurgen

    2017-01-01

    Abstract Background: The current paper includes a systematic search of the literature, a detailed presentation of the results, and a grading of treatment options in terms of efficacy and tolerability/safety. Material and Methods: The PRISMA method was used in the literature search with the combination of the words ‘bipolar,’ ‘manic,’ ‘mania,’ ‘manic depression,’ and ‘manic depressive’ with ‘randomized,’ and ‘algorithms’ with ‘mania,’ ‘manic,’ ‘bipolar,’ ‘manic-depressive,’ or ‘manic depression.’ Relevant web pages and review articles were also reviewed. Results: The current report is based on the analysis of 57 guideline papers and 531 published papers related to RCTs, reviews, posthoc, or meta-analysis papers to March 25, 2016. The specific treatment options for acute mania, mixed episodes, acute bipolar depression, maintenance phase, psychotic and mixed features, anxiety, and rapid cycling were evaluated with regards to efficacy. Existing treatment guidelines were also reviewed. Finally, Tables reflecting efficacy and recommendation levels were created that led to the development of a precise algorithm that still has to prove its feasibility in everyday clinical practice. Conclusions: A systematic literature search was conducted on the pharmacological treatment of bipolar disorder to identify all relevant random controlled trials pertaining to all aspects of bipolar disorder and graded the data according to a predetermined method to develop a precise treatment algorithm for management of various phases of bipolar disorder. It is important to note that the some of the recommendations in the treatment algorithm were based on the secondary outcome data from posthoc analyses. PMID:27816941

  15. Neural mechanisms of childhood-onset bipolar illness.

    Science.gov (United States)

    Post, R M; Leverich, G S; Speer, A M; Xing, G; Weiss, S R

    2000-09-01

    Substantial evidence exists for a cohort effect (earlier onset and increased prevalence) for both unipolar and bipolar affective disorder in every generation born since World War II. This effect could be related to inherited mechanisms (e.g., bi-Hneal pedigrees or genetic anticipation) or to environmental/experiential effects on gene expression (e.g., stressor effects on the induction of transcription and growth factors, enzymes, hormones and their receptors, and signal transduction molecules) as documented in preclinical models of neonatal maternal separation. This laboratory evidence is summarized and new clinical data on the impact of severe stressors on the unfolding course of bipolar illness are noted. The reported occurrence of childhood or adolescent physical or sexual abuse, compared to those who report their absence, is associated with: earlier bipolar illness onset; faster cycling (including ultradian) patterns; increased Axis I and II comorbidities; and increased time ill in a prospective year of follow-up. Selectively, physical abuse was associated with a reported pattern of increasingly severe mania and sexual abuse with increased numbers of serious suicide attempts. In a retrospective survey of parents of children with an approximate average age of 13 who were diagnosed with bipolar illness (compared to those with other diagnoses and those with no diagnosis), a cluster of symptoms related to irritability and dyscontrol differentiated the bipolar children earliest. These symptoms included: temper tantrums, irritability, inattention, hyperactivity, impulsivity, poor frustration tolerance, and increased aggression. Given the growing evidence that episodes of affective dysfunction can not only convey morbidity and mortality, but may also sensitize to further recurrence and thus change the course of illness, opportunities abound for early recognition and intervention in childhood onset bipolar illness. Such a successful endeavor would both allow a more

  16. Scientific attitudes towards bipolar disorders

    Directory of Open Access Journals (Sweden)

    Mohammad-Hossein Biglu

    2014-02-01

    Full Text Available Introduction: Bipolar disorder is a psychiatric condition that is also called manic-depressive disease. It causes unusual changes in mood, energy, activity levels, and the ability to carry out day-to-day tasks. In the present study, 3 sets of data were considered and analyzed: first, all papers categorized under Bipolar Disorders in Science Citation Index Expanded (SCI-E database through 2001-2011; second, papers published by the international journal of Bipolar Disorders indexed in SCI-E during a period of 11 years; and third, all papers distributed by the international journal of Bipolar Disorders indexed in MEDLINE during the period of study. Methods: The SCI-E database was used to extract all papers indexed with the topic of Bipolar Disorders as well as all papers published by The International Journal of Bipolar Disorders. Extraction of data from MEDLINE was restricted to the journals name from setting menu. The Science of Science Tool was used to map the co-authorship network of papers published by The International Journal of Bipolar Disorders through 2009-2011. Results: Analysis of data showed that the majority of publications in the subject area of bipolar disorders indexed in SCI-E were published by The International Journal of Bipolar Disorders. Although journal articles consisted of 59% of the total publication type in SCI-E, 65% of publications distributed by The Journal of Bipolar Disorders were in the form of meetingabstracts. Journal articles consisted of only 23% of the total publications. USA was the leading country regarding sharing data in the field of bipolar disorders followed by England, Canada, and Germany. Conclusion: The editorial policy of The International Journal of Bipolar Disorders has been focused on new themes and new ways of researching in the subject area of bipolar disorder. Regarding the selection of papers for indexing, the SCI-E database selects data more comprehensively than MEDLINE. The number of papers

  17. Bipolar Disorder and Childhood Trauma

    Directory of Open Access Journals (Sweden)

    Evrim Erten

    2015-06-01

    Full Text Available Bipolar disorder is a chronic disorder in which irregular course of depressive, mania or mixed episodes or a complete recovery between episodes can be observed. The studies about the effects of traumatic events on bipolar disorder showed that they had significant and long-term effects on the symptoms of the disorder. Psychosocial stress might change the neurobiology of bipolar disorder over time. The studies revealed that the traumatic events could influence not only the onset of the disorder but also the course of the disorder and in these patients the rate of suicide attempt and comorbid substance abuse might increase. Bipolar patients who had childhood trauma had an earlier onset, higher number of episodes and comorbid disorders. In this review, the relationship between childhood trauma and bipolar disorder is reviewed. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2015; 7(2: 157-165

  18. Epidemiology in Pediatric Bipolar Disorder

    Directory of Open Access Journals (Sweden)

    Caner Mutlu

    2015-12-01

    Full Text Available Childhood and adolescent bipolar disorder diagnosis has been increasing recently. Since studies evaluating attempted suicide rates in children and adolescents have shown bipolarity to be a significant risk factor, diagnosis and treatment of bipolarity has become a very important issue. Since there is a lack of specific diagnostic criteria for especially preadolescent samples and evaluations are made mostly symptomatically, suspicions about false true diagnosis and increased prevalence rates have emerged. This situation leads to controversial data about the prevalence rates of bipolar disorder in children and adolescents. The aim of this article is to review the prevalence of childhood and adolescent bipolar disorder in community, inpatient and outpatient based samples in literature.

  19. Novel multiple criteria decision making methods based on bipolar neutrosophic sets and bipolar neutrosophic graphs

    OpenAIRE

    Muhammad, Akram; Musavarah, Sarwar

    2016-01-01

    In this research study, we introduce the concept of bipolar neutrosophic graphs. We present the dominating and independent sets of bipolar neutrosophic graphs. We describe novel multiple criteria decision making methods based on bipolar neutrosophic sets and bipolar neutrosophic graphs. We also develop an algorithm for computing domination in bipolar neutrosophic graphs.  

  20. Injection moulded low cost bipolar plates for PEM fuel cells

    Science.gov (United States)

    Heinzel, A.; Mahlendorf, F.; Niemzig, O.; Kreuz, C.

    The development of bipolar plates that can be produced by standard mass production techniques is a main issue for the commercialization of PEM fuel cells, as bipolar plates contribute significantly to the cost structure of PEM stacks. In recent years, the University of Duisburg-Essen together with the Zentrum für BrennstoffzellenTechnik GmbH (ZBT) has identified a number of carbon-polymer composites with densities of 1.6 g/cm 3, specific bulk conductivities between 5 and 150 S/cm and material prices between 2 and 10 €/kg. Standard composite mixtures consist of a thermoplast and a carbon compound mixture with additional additives to increase the conductivity of the compound material. The composites generally show high corrosion resistance in the PEM fuel cell environment. Composite material samples proved to be absolutely stable in immersion tests in sulphuric acid and deionized water under pure oxygen atmosphere for several thousand hours. ZBT has successfully demonstrated the production of bipolar plates by injection moulding with cycle times of 30-60 s. With the help of tailored moulds injection moulding of bipolar plates becomes price competitive even for comparatively small series in the range of several thousand plates. PEM stacks with injection moulded bipolar plates of 2.5-4 mm thickness and an electrical power of up to 200 W have been constructed and successfully operated.

  1. Advanced bipolar lead-acid battery for hybrid electric vehicles

    Science.gov (United States)

    Saakes, Michel; Kleijnen, Christian; Schmal, Dick; ten Have, Peter

    A large size 80 V bipolar lead acid battery was constructed and tested successfully with a drive cycle especially developed for a HEV. The bipolar battery was made using the bipolar plate developed at TNO and an optimised paste developed by Centurion. An empirical model was derived for calculating the Ragone plot from the results from a small size 12 V bipolar lead-acid battery. This resulted in a specific power of 340 W/kg for the 80 V module. The Ragone plot was calculated at t=5 and t=10 s after the discharge started for current densities varying from 0.02 to 1.2 A/cm 2. A further development of the bipolar lead-acid battery will result in a specific power of 500 W/kg or more. From the economic analysis we estimate that the price of this high power battery will be in the order of 500 US$/kWh. This price is substantially lower than for comparable high power battery systems. This makes it an acceptable candidate future for HEV.

  2. Peripheral blood brain-derived neurotrophic factor in bipolar disorder

    DEFF Research Database (Denmark)

    Munkholm, K; Vinberg, M; Kessing, L V

    2016-01-01

    Peripheral blood brain-derived neurotrophic factor (BDNF) has been proposed as a potential biomarker related to disease activity and neuroprogression in bipolar disorder, speculated to mirror alterations in brain expression of BDNF. The research area is rapidly evolving; however, recent...... investigations have yielded conflicting results with substantial variation in outcomes, highlighting the need to critically assess the state of current evidence. The aims of the study were to investigate differences in peripheral blood BDNF concentrations between bipolar disorder patients and healthy control......-November 2014) and PsycINFO (1806-November 2014), and 35 studies comprising a total of 3798 participants were included in the meta-analysis. The results indicated that crude peripheral blood BDNF levels may be lower in bipolar disorder patients overall (Hedges' g=-0.28, 95% CI: -0.51 to -0.04, P=0...

  3. Pre-attentive information processing and impulsivity in bipolar disorder.

    Science.gov (United States)

    Swann, Alan C; Lijffijt, Marijn; Lane, Scott D; Steinberg, Joel L; Acas, Michelle D; Cox, Blake; Moeller, F Gerard

    2013-12-01

    Early responses to stimuli can be measured by sensory evoked potentials (EP) using repeated identical stimuli, S1 and S2. Response to S1 may represent efficient stimulus detection, while suppression of response to S2 may represent inhibition. Early responses to stimuli may be related to impulsivity. We compared EP reflecting stimulus detection and inhibition in bipolar disorder and healthy controls, and investigated relationships to impulsivity. Subjects were 48 healthy controls without family histories of mood disorder and 48 with bipolar disorder. EP were measured as latencies and amplitudes for auditory P50 (pre-attentional), N100 (initial direction of attention) and P200 (initial conscious awareness), using a paired-click paradigm, with identical stimuli 0.5 s apart. Impulsivity was measured by questionnaire and by laboratory tests for inability to suppress responses to stimuli or to delay response for a reward. Analyses used general linear models. S1 amplitudes for P50, N100, and P200, and gating of N100 and P200, were lower in bipolar disorder than in controls. P50 S1 amplitude correlated with accurate laboratory-task responding, and S2 amplitude correlated with impulsive task performance and fast reaction times, in bipolar disorder. N100 and P200 EP did not correlate with impulsivity. These findings were independent of symptoms, treatment, or substance-use history. EPs were not related to questionnaire-measured or reward-based impulsivity. Bipolar I disorder is characterized by reduced pre-attentional and early attentional stimulus registration relative to controls. Within bipolar disorder, rapid-response impulsivity correlates with impaired pre-attentional response suppression. These results imply specific relationships between ERP-measured response inhibition and rapid-response impulsivity. Copyright © 2013 Elsevier Ltd. All rights reserved.

  4. Bipolar pulse forming line

    Science.gov (United States)

    Rhodes, Mark A.

    2008-10-21

    A bipolar pulse forming transmission line module for linear induction accelerators having first, second, third, fourth, and fifth planar conductors which form an interleaved stack with dielectric layers between the conductors. Each conductor has a first end, and a second end adjacent an acceleration axis. The first and second planar conductors are connected to each other at the second ends, the fourth and fifth planar conductors are connected to each other at the second ends, and the first and fifth planar conductors are connected to each other at the first ends via a shorting plate adjacent the first ends. The third planar conductor is electrically connectable to a high voltage source, and an internal switch functions to short a high voltage from the first end of the third planar conductor to the first end of the fourth planar conductor to produce a bipolar pulse at the acceleration axis with a zero net time integral. Improved access to the switch is enabled by an aperture through the shorting plate and the proximity of the aperture to the switch.

  5. Yield and seed oil content response of dwarf, rapid-cycling Brassica to nitrogen treatments, planting density, and carbon dioxide enrichment

    Science.gov (United States)

    Frick, J.; Nielsen, S. S.; Mitchell, C. A.

    1994-01-01

    Effects of N level (15 to 30 mM), time of N increase (14 to 28 days after planting), and planting density (1163 to 2093 plants/m2) were determined for crop yield responses of dwarf, rapid-cycling brassica (Brassica napus L., CrGC 5-2, Genome: ACaacc). Crops were grown in solid-matrix hydroponic systems and under controlled-environment conditions, including nonsupplemented (ambient) or elevated CO2 concentrations (998 +/- 12 micromoles mol-1). The highest seed yield rate obtained (4.4 g m-2 day-1) occurred with the lowest N level (15 mM) applied at the latest treatment time (day 28). In all trials, CO2 enrichment reduced seed yield rate and harvest index by delaying the onset of flowering and senescence and stimulating vegetative shoot growth. The highest shoot biomass accumulation rate (55.5 g m-2 day-1) occurred with the highest N level (30 mM) applied at the earliest time (day 14). Seed oil content was not significantly affected by CO2 enrichment. Maximum seed oil content (30% to 34%, dry weight basis) was obtained using the lowest N level (15 mM) initiated at the latest treatment time (day 28). In general, an increase in seed oil content was accompanied by a decrease in seed protein. Seed carbohydrate, moisture, and ash contents did not vary significantly in response to experimental treatments. Effects of N level and time of N increase were consistently significant for most crop responses. Planting density was significant only under elevated CO2 conditions.

  6. Beyond genomic variation--comparison and functional annotation of three Brassica rapa genomes: a turnip, a rapid cycling and a Chinese cabbage.

    Science.gov (United States)

    Lin, Ke; Zhang, Ningwen; Severing, Edouard I; Nijveen, Harm; Cheng, Feng; Visser, Richard G F; Wang, Xiaowu; de Ridder, Dick; Bonnema, Guusje

    2014-03-31

    Brassica rapa is an economically important crop species. During its long breeding history, a large number of morphotypes have been generated, including leafy vegetables such as Chinese cabbage and pakchoi, turnip tuber crops and oil crops. To investigate the genetic variation underlying this morphological variation, we re-sequenced, assembled and annotated the genomes of two B. rapa subspecies, turnip crops (turnip) and a rapid cycling. We then analysed the two resulting genomes together with the Chinese cabbage Chiifu reference genome to obtain an impression of the B. rapa pan-genome. The number of genes with protein-coding changes between the three genotypes was lower than that among different accessions of Arabidopsis thaliana, which can be explained by the smaller effective population size of B. rapa due to its domestication. Based on orthology to a number of non-brassica species, we estimated the date of divergence among the three B. rapa morphotypes at approximately 250,000 YA, far predating Brassica domestication (5,000-10,000 YA). By analysing genes unique to turnip we found evidence for copy number differences in peroxidases, pointing to a role for the phenylpropanoid biosynthesis pathway in the generation of morphological variation. The estimated date of divergence among three B. rapa morphotypes implies that prior to domestication there was already considerably divergence among B. rapa genotypes. Our study thus provides two new B. rapa reference genomes, delivers a set of computer tools to analyse the resulting pan-genome and uses these to shed light on genetic drivers behind the rich morphological variation found in B. rapa.

  7. Staging systems in bipolar disorder: an International Society for Bipolar Disorders Task Force Report

    NARCIS (Netherlands)

    Kapczinski, F.; Magalhaes, P.V.S.; Balanza-Martinez, V.; Dias, V.V.; Frangou, S.; Gama, C.S.; Gonzalez-Pinto, A.; Kupka, R.W.

    2014-01-01

    Objective: We discuss the rationale behind staging systems described specifically for bipolar disorders. Current applications, future directions and research gaps in clinical staging models for bipolar disorders are outlined. Method: We reviewed the literature pertaining to bipolar disorders,

  8. Bipolar affective disorder and gender

    OpenAIRE

    Dias, Rogerio [UNESP; Kerr-Corrêa, Florence [UNESP; Torresan, Ricardo Cezar [UNESP; Dos Santos, Carlos Henrique R.

    2006-01-01

    Embora o transtorno bipolar (TB) ocorra quase igualmente em ambos os sexos, a fenomenologia e o curso da doença diferem no homem e na mulher. No entanto, há evidências de que mulheres bipolares, mais que os homens, apresentariam início mais tardio (em especial na quinta década de vida), ciclagem rápida, mais episódios depressivos, mais mania disfórica que eufórica, estados mistos e evolução do tipo bipolar II, ainda que os achados nem sempre sejam consistentes. Embora o risco de comorbidades ...

  9. Dysfunctional assumptions in bipolar disorder.

    Science.gov (United States)

    Lam, Dominic; Wright, Kim; Smith, Neil

    2004-04-01

    Despite the initial encouraging outcome in developing CBT for bipolar affective disorder [Arch. Gen. Psychiatry 2002 (in press); Psychol. Med. 31 (2001) 459-467], very little is known about whether there are any differences in dysfunctional attitudes between unipolar and bipolar patients. Both the behavioural activation system theory [J. Pers. Soc. Psychol. 67 (1994) 488-498; Major Theories of Personality Disorder, Guilford Press, New York, 1996; Psychol. Bull. 117 (1995) 434-449] and the cognitive model for bipolar affective disorder [Cognitive Therapy for Bipolar Disorder: A Therapist's Guide to Concepts, Methods and Practise, Wiley, New York, 1999] postulate high goal striving as a risk factor for bipolar disorder. However, the existing subscales in the dysfunctional attitude scale (DAS) were derived from patients and relatives of patients suffering from unipolar depression, patients with a mixed psychiatric diagnosis or normal controls. None of the existing subscales reflects high goal striving beliefs. Using a sample of bipolar patients may yield different factors. A total of 143 bipolar 1 patients filled in the short version of DAS 24. Principal component analysis was carried out to derive factors. The scores of these factors were compared with those of 109 unipolar patients to investigate if these factors distinguish bipolar patients from unipolar patients. Three factors were derived: factor 1 'Goal-attainment' accounted for 25.0% of the total variance. Factor 2 'Dependency' accounted for 11.0% of the total variance. Factor 3 'Achievement' accounted for 8.2% of the total variance. However, factor 1 appeared to consist of items that made a coherent theoretical construct. No significant differences were found when the validation sample was compared with 109 patients suffering from unipolar depression in any of the three factors. When subjects who were likely to be in a major depressive episode were excluded, the scores of bipolar patients (n=49) were

  10. Asenapine for bipolar disorder

    Directory of Open Access Journals (Sweden)

    Scheidemantel T

    2015-12-01

    Full Text Available Thomas Scheidemantel,1 Irina Korobkova,2 Soham Rej,3,4 Martha Sajatovic1,2 1University Hospitals Case Medical Center, 2Case Western Reserve University School of Medicine, Cleveland, OH, USA; 3Department of Psychiatry, University of Toronto, Toronto, ON, 4Geri PARTy Research Group, Jewish General Hospital, Montreal, QC, Canada Abstract: Asenapine (Saphris® is an atypical antipsychotic drug which has been approved by the US Food and Drug Administration for the treatment of schizophrenia in adults, as well as the treatment of acute manic or mixed episodes of bipolar I in both adult and pediatric populations. Asenapine is a tetracyclic drug with antidopaminergic and antiserotonergic activity with a unique sublingual route of administration. In this review, we examine and summarize the available literature on the safety, efficacy, and tolerability of asenapine in the treatment of bipolar disorder (BD. Data from randomized, double-blind trials comparing asenapine to placebo or olanzapine in the treatment of acute manic or mixed episodes showed asenapine to be an effective monotherapy treatment in clinical settings; asenapine outperformed placebo and showed noninferior performance to olanzapine based on improvement in the Young Mania Rating Scale scores. There are limited data available on the use of asenapine in the treatment of depressive symptoms of BD, or in the maintenance phase of BD. The available data are inconclusive, suggesting the need for more robust data from prospective trials in these clinical domains. The most commonly reported adverse effect associated with use of asenapine is somnolence. However, the somnolence associated with asenapine use did not cause significant rates of discontinuation. While asenapine was associated with weight gain when compared to placebo, it appeared to be modest when compared to other atypical antipsychotics, and its propensity to cause increases in hemoglobin A1c or serum lipid levels appeared to be

  11. Development and testing of a bipolar lead-acid battery for hybrid electric vehicles

    NARCIS (Netherlands)

    Mourad, S.; Saakes, M.; Kluiters, C.E.; Schmal, D.; Have, P. ten

    1998-01-01

    A 80V bipolar lead-acid battery was constructed and tested using Hybrid Electric Vehicle (HEV) drive cycles. Drive cycles with a peak power of 6.7kW, equal to 1/5 of the total power profile required for the HEV studied, were run succesfully. Model calculations showed that the constructed 80V module,

  12. Development and testing of a bipolar lead-acid battery for hybrid electric vehicles

    NARCIS (Netherlands)

    Saakes, M.; Kluiters, E.; Schmal, D.; Mourad, S.; Have, P.T.J.H. ten

    1999-01-01

    An 80 V bipolar lead-acid battery was constructed and tested using hybrid electric vehicle (HEV) drive cycles. Drive cycles with a peak power of 6.7 kW, equal to 1/5 of the total power profile required for the HEV studied, were run successfully. Model calculations showed that the 80 V module

  13. Ion bipolar junction transistors.

    Science.gov (United States)

    Tybrandt, Klas; Larsson, Karin C; Richter-Dahlfors, Agneta; Berggren, Magnus

    2010-06-01

    Dynamic control of chemical microenvironments is essential for continued development in numerous fields of life sciences. Such control could be achieved with active chemical circuits for delivery of ions and biomolecules. As the basis for such circuitry, we report a solid-state ion bipolar junction transistor (IBJT) based on conducting polymers and thin films of anion- and cation-selective membranes. The IBJT is the ionic analogue to the conventional semiconductor BJT and is manufactured using standard microfabrication techniques. Transistor characteristics along with a model describing the principle of operation, in which an anionic base current amplifies a cationic collector current, are presented. By employing the IBJT as a bioelectronic circuit element for delivery of the neurotransmitter acetylcholine, its efficacy in modulating neuronal cell signaling is demonstrated.

  14. Big data for bipolar disorder

    National Research Council Canada - National Science Library

    Monteith, Scott; Glenn, Tasha; Geddes, John; Whybrow, Peter C; Bauer, Michael

    2016-01-01

    .... The impact of big data on the routine treatment of bipolar disorder today and in the near future is discussed, with examples that relate to health policy, the discovery of new associations, and the study of rare events...

  15. Genetics Home Reference: bipolar disorder

    Science.gov (United States)

    ... 7 Genetic Testing Registry: Major affective disorder 8 Genetic Testing Registry: Major affective disorder 9 Other Diagnosis and Management Resources (5 links) Depression and Bipolar Support Alliance: Finding the Right Treatment ...

  16. Mood dynamics in bipolar disorder

    OpenAIRE

    Moore, Paul J; Little, Max A; McSharry, Patrick E; Goodwin, Guy M; Geddes, John R

    2014-01-01

    The nature of mood variation in bipolar disorder has been the subject of relatively little research because detailed time series data has been difficult to obtain until recently. However some papers have addressed the subject and claimed the presence of deterministic chaos and of stochastic nonlinear dynamics. This study uses mood data collected from eight outpatients using a telemonitoring system. The nature of mood dynamics in bipolar disorder is investigated using surrogate data techniques...

  17. Design study of the large hadron electron collider and a rapid cycling synchrotron as alternative to the PS booster upgrade at CERN

    Energy Technology Data Exchange (ETDEWEB)

    Fitterer, Miriam

    2013-02-22

    With the Large Hadron Collider (LHC) the exploration of particle physics at center of mass energies at the TeV scale has begun. To extend the discovery potential of the LHC, a major upgrade is foreseen around 2020 of the LHC itself and the LHC injectors - the chain of accelerators preparing the beam for the LHC. One of the injectors - the second one in the chain - is the Proton Synchrotron (PS) Booster. Its performance is currently limited by the space-charge effect, which is the effect of the electromagnetic field of the particle beam on itself. This effect becomes weaker with higher energy, and therefore an energy upgrade of the PS Booster to 2 GeV maximum beam energy is foreseen. As the PS Booster is with its 40 years already an old machine, the construction of a new accelerator, a Rapid Cycling Synchrotron (RCS), to replace the PS Booster has been proposed. In this thesis different options for the beam guidance in the RCS - referred to as lattice and optics - are studied, followed by a more general comparison of different lattices and optics and their performance under consideration of the space-charge effect. To further complement the LHC physics program, also the possibility of deep inelastic lepton-nucleon scattering at the LHC has been suggested, referred to as Large Hadron Electron Collider (LHeC). In this case the proton beam of the LHC collides with the electron beam, which is accelerated in a separate newly built machine. Two options are considered as electron accelerator: a new energy recovery linac - the Linac-Ring option - and the installation of an electron ring in the existing LHC tunnel - the Ring-Ring option. One of the main challenges of the Ring-Ring option is the integration of the electron ring in the current LHC tunnel. A layout, lattice and optics of the electron accelerator is developed in this thesis, which meets the requirements with regard to integration and reaches the beam parameters demanded by the particle physics experiments.

  18. Life expectancy in bipolar disorder.

    Science.gov (United States)

    Kessing, Lars Vedel; Vradi, Eleni; Andersen, Per Kragh

    2015-08-01

    Life expectancy in patients with bipolar disorder has been reported to be decreased by 11 to 20 years. These calculations are based on data for individuals at the age of 15 years. However, this may be misleading for patients with bipolar disorder in general as most patients have a later onset of illness. The aim of the present study was to calculate the remaining life expectancy for patients of different ages with a diagnosis of bipolar disorder. Using nationwide registers of all inpatient and outpatient contacts to all psychiatric hospitals in Denmark from 1970 to 2012 we calculated remaining life expectancies for values of age 15, 25, 35 ⃛ 75 years among all individuals alive in year 2000. For the typical male or female patient aged 25 to 45 years, the remaining life expectancy was decreased by 12.0-8.7 years and 10.6-8.3 years, respectively. The ratio between remaining life expectancy in bipolar disorder and that of the general population decreased with age, indicating that patients with bipolar disorder start losing life-years during early and mid-adulthood. Life expectancy in bipolar disorder is decreased substantially, but less so than previously reported. Patients start losing life-years during early and mid-adulthood. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. Threat sensitivity in bipolar disorder.

    Science.gov (United States)

    Muhtadie, Luma; Johnson, Sheri L

    2015-02-01

    Life stress is a major predictor of the course of bipolar disorder. Few studies have used laboratory paradigms to examine stress reactivity in bipolar disorder, and none have assessed autonomic reactivity to laboratory stressors. In the present investigation we sought to address this gap in the literature. Participants, 27 diagnosed with bipolar I disorder and 24 controls with no history of mood disorder, were asked to complete a complex working memory task presented as "a test of general intelligence." Self-reported emotions were assessed at baseline and after participants were given task instructions; autonomic physiology was assessed at baseline and continuously during the stressor task. Compared to controls, individuals with bipolar disorder reported greater increases in pretask anxiety from baseline and showed greater cardiovascular threat reactivity during the task. Group differences in cardiovascular threat reactivity were significantly correlated with comorbid anxiety in the bipolar group. Our results suggest that a multimethod approach to assessing stress reactivity-including the use of physiological parameters that differentiate between maladaptive and adaptive profiles of stress responding-can yield valuable information regarding stress sensitivity and its associations with negative affectivity in bipolar disorder. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

  20. Sleep Disturbance in Bipolar Disorder Across the Lifespan

    OpenAIRE

    Harvey, Allison G.; Talbot, Lisa S.; Gershon, Anda

    2009-01-01

    The aim of this article is to highlight the importance of the sleep–wake cycle in children, adolescents, and adults with bipolar disorder. After reviewing the evidence that has accrued to date on the nature and severity of the sleep disturbance experienced, we document the importance of sleep for quality of life, risk for relapse, affective functioning, cognitive functioning, health (sleep disturbance is implicated in obesity, poor diet, and inadequate exercise), impulsivity, and risk taking....

  1. The last deglaciation: timing the bipolar seesaw

    Directory of Open Access Journals (Sweden)

    J. B. Pedro

    2011-06-01

    Full Text Available Precise information on the relative timing of north-south climate variations is a key to resolving questions concerning the mechanisms that force and couple climate changes between the hemispheres. We present a new composite record made from five well-resolved Antarctic ice core records that robustly represents the timing of regional Antarctic climate change during the last deglaciation. Using fast variations in global methane gas concentrations as time markers, the Antarctic composite is directly compared to Greenland ice core records, allowing a detailed mapping of the inter-hemispheric sequence of climate changes. Consistent with prior studies the synchronized records show that warming (and cooling trends in Antarctica closely match cold (and warm periods in Greenland on millennial timescales. For the first time, we also identify a sub-millennial component to the inter-hemispheric coupling. Within the Antarctic Cold Reversal the strongest Antarctic cooling occurs during the pronounced northern warmth of the Bølling. Warming then resumes in Antarctica, potentially as early as the Intra-Allerød Cold Period, but with dating uncertainty that could place it as late as the onset of the Younger Dryas stadial. There is little-to-no time lag between climate transitions in Greenland and opposing changes in Antarctica. Our results lend support to fast acting inter-hemispheric coupling mechanisms, including recently proposed bipolar atmospheric teleconnections and/or rapid bipolar ocean teleconnections.

  2. Verbal abuse, like physical and sexual abuse, in childhood is associated with an earlier onset and more difficult course of bipolar disorder.

    Science.gov (United States)

    Post, Robert M; Altshuler, Lori L; Kupka, Ralph; McElroy, Susan L; Frye, Mark A; Rowe, Michael; Leverich, Gabriele S; Grunze, Heinz; Suppes, Trisha; Keck, Paul E; Nolen, Willem A

    2015-05-01

    Physical or sexual abuse in childhood is known to have an adverse effect on the course of bipolar disorder, but the impact of verbal abuse has not been well elucidated. We examined the occurrence and frequency (never to frequently) of each type of abuse in childhood in 634 US adult outpatients (average age 40 years). Patients gave informed consent and provided information about their age of onset and course of illness prior to study entry. Verbal abuse alone occurred in 24% of the patients. Similar to a history of physical or sexual abuse, a history of verbal abuse was related to an earlier age of onset of bipolar disorder and other poor prognosis characteristics, including anxiety and substance abuse comorbidity, rapid cycling, and a deteriorating illness course as reflected in ratings of increasing frequency or severity of mania and depression. A lasting adverse impact of the experience of verbal abuse in childhood is suggested by its relationship to an earlier age of onset of bipolar disorder, other poor prognosis factors, and a deteriorating course of illness. Verbal abuse is a common confound in comparison groups defined by a lack of physical or sexual abuse. Ameliorating the impact of verbal abuse on the unfolding course of bipolar disorder appears to be an important target of therapeutics and worthy of attempts at primary and secondary prophylaxis. Family-based treatments that focus on psychoeducation, enhancing intra-family communication, and coping skills may be particularly helpful. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  3. Bipolar Disorder and Alcoholism: Are They Related?

    Science.gov (United States)

    ... Are they related? Is there a connection between bipolar disorder and alcoholism? Answers from Daniel K. Hall-Flavin, M.D. Bipolar disorder and alcoholism often occur together. Although the association ...

  4. Anticonvulsivantes e antipsicóticos no tratamento do transtorno bipolar Anticonvulsants and antipsychotics in the treatment of Bipolar Disorder

    Directory of Open Access Journals (Sweden)

    Ricardo Alberto Moreno

    2004-10-01

    effective in acute manic episodes. Lamotrigine has been shown to reduce cycling and effective in depressive episodes. Based on the available data, olanzapine was found to be the most appropriate atypical antipsychotic agent for the treatment of manic bipolar patients, although there are also studies suggesting the efficacy of risperidone, aripiprazole and clozapine. The preliminary data evaluating the efficacy of quetiapine and ziprasidone in bipolar disorder are still very limited. There is no consistent information supporting the prophylactic use of newer antipsychotics.

  5. Aurora A, mitotic entry, and spindle bipolarity

    Science.gov (United States)

    Liu, Quentin; Ruderman, Joan V.

    2006-01-01

    The kinase Aurora-A (Aur-A), which is enriched at centrosomes, is required for centrosome maturation and accurate chromosome segregation, and recent work implicates centrosomes as sites where the earliest activation of cyclin B1-cdc2 occurs. Here, we have used Xenopus egg extracts to investigate Aur-A's contribution to cell cycle progression and spindle morphology in the presence or absence of centrosomes. We find that addition of active Aur-A accelerates cdc2 activation and mitotic entry. Depletion of endogenous Aur-A or addition of inactive Aur-A, which lead to monopolar spindles, delays but does not block mitotic entry. These effects on timing and spindle structure do not require the presence of centrosomes or chromosomes. The catalytic domain alone of Aur-A is sufficient to restore spindle bipolarity; additional N-terminal sequences function in mitotic timing. PMID:16581905

  6. [Genetics of bipolar disorder].

    Science.gov (United States)

    Budde, M; Forstner, A J; Adorjan, K; Schaupp, S K; Nöthen, M M; Schulze, T G

    2017-07-01

    Bipolar disorder (BD) has a multifactorial etiology. Its development is influenced by genetic as well as environmental factors. Large genome-wide association studies (GWAS), in which genetic risk allelic variants for the disorder could be replicated for the first time, marked the breakthrough in the identification of the responsible risk genes. In addition to these common genetic variants with moderate effects identified by GWAS, rare variants with a higher penetrance are expected to play a role in disease development. The results of recent studies suggest that copy number variants might contribute to BD development, although to a lesser extent than in other psychiatric disorders, such as schizophrenia or autism. Results from the initial next generation sequencing studies indicate an enrichment of rare variants in pathways and genes that were previously found to be associated with BD. In the field of pharmacogenetics, a risk gene that influences the individual variance in the response to lithium treatment was identified for the first time in a recent large international GWAS. Currently the reported risk alleles do not sufficiently explain the phenotypic variance to be used for individual prediction of disease risk, disease course or response to medication. Future genetic research will provide important insights into the biological basis of BD by the identification of additional genes associated with BD. This knowledge of genetics will help identify potential etiological subgroups as well as cross-diagnostic disease mechanisms.

  7. Treatment of bipolar disorder

    Science.gov (United States)

    2013-01-01

    We review recent developments in the acute and long-term treatment of bipolar disorder and identify promising future routes to therapeutic innovation. Overall, advances in drug treatment remain quite modest. Antipsychotic drugs are effective in the acute treatment of mania; their efficacy in the treatment of depression is variable with the clearest evidence for quetiapine. Despite their widespread use, considerable uncertainty and controversy remains about the use of antidepressant drugs in the management of depressive episodes. Lithium has the strongest evidence for long-term relapse prevention; the evidence for anticonvulsants such as divalproex and lamotrigine is less robust and there is much uncertainty about the longer term benefits of antipsychotics. Substantial progress has been made in the development and assessment of adjunctive psychosocial interventions. Long-term maintenance and possibly acute stabilisation of depression can be enhanced by the combination of psychosocial treatments with drugs. The development of future treatments should consider both the neurobiological and psychosocial mechanisms underlying the disorder. We should continue to repurpose treatments and to recognise the role of serendipity. We should also investigate optimum combinations of pharmacological and psychotherapeutic treatments at different stages of the illness. Clarification of the mechanisms by which different treatments affect sleep and circadian rhythms and their relation with daily mood fluctuations is likely to help with the treatment selection for individual patients. To be economically viable, existing psychotherapy protocols need to be made briefer and more efficient for improved scalability and sustainability in widespread implementation. PMID:23663953

  8. Targeting astrocytes in bipolar disorder.

    Science.gov (United States)

    Peng, Liang; Li, Baoman; Verkhratsky, Alexei

    2016-06-01

    Astrocytes are homeostatic cells of the central nervous system, which are critical for development and maintenance of synaptic transmission and hence of synaptically connected neuronal ensembles. Astrocytic densities are reduced in bipolar disorder, and therefore deficient astroglial function may contribute to overall disbalance in neurotransmission and to pathological evolution. Classical anti-bipolar drugs (lithium salts, valproic acid and carbamazepine) affect expression of astroglial genes and modify astroglial signalling and homeostatic cascades. Many effects of both antidepressant and anti-bipolar drugs are exerted through regulation of glutamate homeostasis and glutamatergic transmission, through K(+) buffering, through regulation of calcium-dependent phospholipase A2 (that controls metabolism of arachidonic acid) or through Ca(2+) homeostatic and signalling pathways. Sometimes anti-depressant and anti-bipolar drugs exert opposite effects, and some effects on gene expression in drug treated animals are opposite in neurones vs. astrocytes. Changes in the intracellular pH induced by anti-bipolar drugs affect uptake of myo-inositol and thereby signalling via inositoltrisphosphate (InsP3), this being in accord with one of the main theories of mechanism of action for these drugs.

  9. Sleep homeostatic pressure and PER3 VNTR gene polymorphism influence antidepressant response to sleep deprivation in bipolar depression.

    Science.gov (United States)

    Dallaspezia, Sara; Locatelli, Clara; Lorenzi, Cristina; Pirovano, Adele; Colombo, Cristina; Benedetti, Francesco

    2016-03-01

    Combined Total sleep deprivation (TSD) and light therapy (LT) cause a rapid improvement in bipolar depression which has been hypothesized to be paralleled by changes in sleep homeostasis. Recent studies showed that bipolar patients had lower changes of EEG theta power after sleep and responders to antidepressant TSD+LT slept less and showed a lower increase of EEG theta power then non-responders. A polymorphism in PER3 gene has been associated with diurnal preference, sleep structure and homeostatic response to sleep deprivation in healthy subjects. We hypothesized that the individual variability in the homeostatic response to TSD could be a correlate of antidepressant response and be influenced by genetic factors. We administered three TSD+LT cycles to bipolar depressed patients. Severity of depression was rated on Hamilton Depression Rating Scale. Actigraphic recordings were performed in a group of patients. PER3 polymorphism influenced changes in total sleep time (F=2.24; p=0.024): while PER3(4/4) and PER3(4/5) patients showed a reduction in it after treatment, PER3(5/5) subjects showed an increase of about 40min, suggesting a higher homeostatic pressure. The same polymorphism influenced the change of depressive symptomatology during treatment (F=3.72; p=0.028). Sleep information was recorded till the day after the end of treatment: a longer period of observation could give more information about the possible maintenance of allostatic adaptation. A higher sleep homeostatic pressure reduced the antidepressant response to TSD+LT, while an allostatic adaptation to sleep loss was associated with better response. This process seems to be under genetic control. Copyright © 2015 Elsevier B.V. All rights reserved.

  10. Clozapine for treatment-resistant bipolar disorder: a systematic review.

    Science.gov (United States)

    Li, Xian-Bin; Tang, Yi-Lang; Wang, Chuan-Yue; de Leon, Jose

    2015-05-01

    To evaluate the efficacy and safety of clozapine for treatment-resistant bipolar disorder (TRBD). A systematic review of randomized controlled studies, open-label prospective studies, and retrospective studies of patients with TRBD was carried out. Interventions included clozapine monotherapy or clozapine combined with other medications. Outcome measures were efficacy and adverse drug reactions (ADRs). Fifteen clinical trials with a total sample of 1,044 patients met the inclusion criteria. Clozapine monotherapy or clozapine combined with other treatments for TRBD was associated with improvement in: (i) symptoms of mania, depression, rapid cycling, and psychotic symptoms, with many patients with TRBD achieving a remission or response; (ii) the number and duration of hospitalizations, the number of psychotropic co-medications, and the number of hospital visits for somatic reasons for intentional self-harm/overdose; (iii) suicidal ideation and aggressive behavior; and (iv) social functioning. In addition, patients with TRBD showed greater clinical improvement in long-term follow-up when compared with published schizophrenia data. Sedation (12%), constipation (5.0%), sialorrhea (5.2%), weight gain (4%), and body ache/pain (2%) were the commonly reported ADRs; however, these symptoms but did not usually require drug discontinuation. The percentage of severe ADRs reported, such as leukopenia (2%), agranulocytosis (0.3%), and seizure (0.5%), appeared to be lower than those reported in the published schizophrenia literature. The limited current evidence supports the concept that clozapine may be both an effective and a relatively safe medication for TRBD. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. Life expectancy in bipolar disorder

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel; Vradi, Eleni; Andersen, Per Kragh

    2015-01-01

    OBJECTIVE: Life expectancy in patients with bipolar disorder has been reported to be decreased by 11 to 20 years. These calculations are based on data for individuals at the age of 15 years. However, this may be misleading for patients with bipolar disorder in general as most patients have a later...... onset of illness. The aim of the present study was to calculate the remaining life expectancy for patients of different ages with a diagnosis of bipolar disorder. METHODS: Using nationwide registers of all inpatient and outpatient contacts to all psychiatric hospitals in Denmark from 1970 to 2012 we...... calculated remaining life expectancies for values of age 15, 25, 35 ⃛ 75 years among all individuals alive in year 2000. RESULTS: For the typical male or female patient aged 25 to 45 years, the remaining life expectancy was decreased by 12.0-8.7 years and 10.6-8.3 years, respectively. The ratio between...

  12. Bipolar illness, creativity, and treatment.

    Science.gov (United States)

    Rothenberg, A

    2001-01-01

    There have been in recent years increasing claims in both popular and professional literature for a connection between bipolar illness and creativity. A review of studies supporting this claim reveals serious flaws in sampling, methodology, presentation of results, and conclusions. Although there is therefore no evidence for etiological or genetic linkages, it is still necessary to explain interrelationships in those creative persons suffering from the illness. Examples of the work in progress of artists with bipolar disorder, Jackson Pollock and Edvard Munch, illustrate the use of healthy and adaptive creative cognition--janusian and homospatial processes--in the former's breakthrough conception during an improvement phase in treatment leading to the development of the Abstract Expressionist Movement and in the latter's transformation of an hallucination into his famous artwork "The Scream." Treatment options that do not produce cognitive effects are important for creative persons with bipolar disorder.

  13. Functional Remediation for Bipolar Disorder

    Science.gov (United States)

    Martínez-Arán, Anabel; Torrent, Carla; Solé, Brisa; Bonnín, C. Mar; Rosa, Adriane R; Sánchez-Moreno, José; Vieta, Eduard

    2011-01-01

    Neurocognitive impairment constitutes a core feature of bipolar illness. The main domains affected are verbal memory, attention, and executive functions. Deficits in these areas as well as difficulties to get functional remission seem to be increased associated with illness progression. Several studies have found a strong relationship between neurocognitive impairment and low functioning in bipolar disorder, as previously reported in other illnesses such as schizophrenia. Cognitive remediation strategies, adapted from work conducted with traumatic brain injury patients and applied to patients with schizophrenia, also need to be adapted to individuals with bipolar disorders. Early intervention using functional remediation, involves neurocognitive techniques and training, but also psychoeducation on cognition-related issues and problem-solving within an ecological framework. PMID:21687565

  14. Psychoterapeutic approach in bipolar disorder

    OpenAIRE

    Knapp, Paulo; Isolan, Luciano

    2005-01-01

    Embora o tratamento farmacológico seja essencial para o tratamento do transtorno bipolar, apenas 40% de todos os pacientes que aderem às medicações permanecem assintomáticos durante o período de seguimento, o que tem levado ao desenvolvimento de intervenções psicoterápicas associadas. O objetivo deste artigo é examinar as evidências atuais da eficácia de intervenções psicoterápicas no tratamento do transtorno bipolar. Foi realizada uma pesquisa bibliográfica por meio do MedLine, PsychoINFO, L...

  15. Rapid and Specific Detection of Amantadine-Resistant Influenza A Viruses with a Ser31Asn Mutation by the Cycling Probe Method▿

    Science.gov (United States)

    Suzuki, Yasushi; Saito, Reiko; Zaraket, Hassan; Dapat, Clyde; Caperig-Dapat, Isolde; Suzuki, Hiroshi

    2010-01-01

    Amantadine is one of the antiviral agents used to treat influenza A virus infections, but resistant strains have widely emerged worldwide. In the present study, we developed a novel method to detect amantadine-resistant strains harboring the Ser31Asn mutation in the M2 gene based on the cycling probe method and real-time PCR. We also studied the rate of amantadine resistance in the 2007-2008 influenza season in Japan. Two different primer and cycling probe sets were designed for A/H1N1 and A/H3N2 each to detect a single nucleotide polymorphism corresponding to Ser/Asn at residue 31 of the M2 protein. By using nasopharyngeal swabs from patients with influenza-like and other respiratory illnesses and virus isolates, the specificity and the sensitivity of the cycling probe method were evaluated. High frequencies of amantadine resistance were detected among the A/H1N1 (411/663, 62%) and A/H3N2 (56/56, 100%) virus isolates collected from six prefectures in Japan in the 2007-2008 influenza season. We confirmed that the cycling probe method is suitable for the screening of both nasopharyngeal swabs and influenza virus isolates for amantadine-resistant strains and showed that the incidence of amantadine resistance among both A/H1N1 and A/H3N2 viruses remained high in Japan during the 2007-2008 season. PMID:19889895

  16. Sleep Disturbance in Bipolar Disorder Across the Lifespan.

    Science.gov (United States)

    Harvey, Allison G; Talbot, Lisa S; Gershon, Anda

    2009-06-01

    The aim of this article is to highlight the importance of the sleep-wake cycle in children, adolescents, and adults with bipolar disorder. After reviewing the evidence that has accrued to date on the nature and severity of the sleep disturbance experienced, we document the importance of sleep for quality of life, risk for relapse, affective functioning, cognitive functioning, health (sleep disturbance is implicated in obesity, poor diet, and inadequate exercise), impulsivity, and risk taking. We argue that sleep may be critically important in the complex multifactorial cause of interepisode dysfunction, adverse health outcomes, and relapse. An agenda for future research is presented that includes improving the quality of sleep measures and controlling for the impact of bipolar medications.

  17. EEI`s wafer-cell bipolar battery: Versatile technology for a variety of military systems

    Energy Technology Data Exchange (ETDEWEB)

    Brown, J.T.; Klein, M.G.; Reisner, D.E. [Electro Energy, Inc., Danbury, CT (United States)

    1996-11-01

    A new versatile cell design based on stackable wafer cells is described which forms the unit building block of a new generation of bipolar battery systems for a wide variety of military applications. Current is transported across an outer envelope of conductive plastic film. This innovative bipolar design approach offers improved energy density based on more efficient packaging in prismatic containers as well as elimination of cell hardware. Higher power capability is achieved from the intrinsic low resistance operation in a bipolar mode. These performance improvements are achieved in a low-cost package by virtue of the design simplicity and use of non-graphitic plastic-bonded electrodes. EEI has demonstrated the viability of the wafer cell approach in Ni-MH with sealed cell cycle life in excess of 2,000 cycles. Results are also reported for Ag-MH.

  18. Mixed features in bipolar disorder.

    Science.gov (United States)

    Solé, Eva; Garriga, Marina; Valentí, Marc; Vieta, Eduard

    2017-04-01

    Mixed affective states, defined as the coexistence of depressive and manic symptoms, are complex presentations of manic-depressive illness that represent a challenge for clinicians at the levels of diagnosis, classification, and pharmacological treatment. The evidence shows that patients with bipolar disorder who have manic/hypomanic or depressive episodes with mixed features tend to have a more severe form of bipolar disorder along with a worse course of illness and higher rates of comorbid conditions than those with non-mixed presentations. In the updated Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5), the definition of "mixed episode" has been removed, and subthreshold nonoverlapping symptoms of the opposite pole are captured using a "with mixed features" specifier applied to manic, hypomanic, and major depressive episodes. However, the list of symptoms proposed in the DSM-5 specifier has been widely criticized, because it includes typical manic symptoms (such as elevated mood and grandiosity) that are rare among patients with mixed depression, while excluding symptoms (such as irritability, psychomotor agitation, and distractibility) that are frequently reported in these patients. With the new classification, mixed depressive episodes are three times more common in bipolar II compared with unipolar depression, which partly contributes to the increased risk of suicide observed in bipolar depression compared to unipolar depression. Therefore, a specific diagnostic category would imply an increased diagnostic sensitivity, would help to foster early identification of symptoms and ensure specific treatment, as well as play a role in suicide prevention in this population.

  19. Influence of homo-buffer layers and post-deposition rapid thermal annealing upon atomic layer deposition grown ZnO at 100 °C with three-pulsed precursors per growth cycle

    Science.gov (United States)

    Cheng, Yung-Chen; Yuan, Kai-Yun; Chen, Miin-Jang

    2017-10-01

    ZnO main epilayers are deposited with three-pulsed precursors in every growth cycle at 100 °C on various thicknesses of 300 °C-grown homo-buffer layers by atomic layer deposition (ALD) on sapphire substrate. Samples are treated without and with post-deposition rapid thermal annealing (RTA). Two different annealing temperatures 300 and 1000 °C are utilized in the ambience of oxygen for 5 min. Extremely low background electron concentration 8.4 × 1014 cm-3, high electron mobility 62.1 cm2/V s, and pronounced enhancement of near bandgap edge photoluminescence (PL) are achieved for ZnO main epilayer with sufficient thickness of buffer layer (200 ALD cycles) and post-deposition RTA at 1000 °C. Effective block and remove of thermally unstable mobile defects and other crystal lattice imperfections are the agents of quality promotion of ZnO thin film.

  20. Rapid Refresh (RAP) [13 km

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Rapid Refresh (RAP) numerical weather model took the place of the Rapid Update Cycle (RUC) on May 1, 2012. Run by the National Centers for Environmental...

  1. Rapid Refresh (RAP) [20 km

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Rapid Refresh (RAP) numerical weather model took the place of the Rapid Update Cycle (RUC) on May 1, 2012. Run by the National Centers for Environmental...

  2. DMFC bipolar material and new processing for μDMFC microchannel

    Science.gov (United States)

    Yin, Bifeng; Guan, Tao; Wang, Yun

    2010-10-01

    DMFC (Direct Methanol Fuel Cell) is attractive as green energy with the characteristics of high energy conversion rate, lower carbon and emission, eco-friendly alternative energy. In DMFC, bipolar plate is one key component because of its high performance requirements, the bipolar plate nearly always makes about 60% contribution to the cost of all fuel cell, seriously affected the commercialization progress of DMFC. Furthermore, the flow channel design and arrangement in bipolar plate has a great influence on water and heat management, distribution of reactants and smooth resultant discharge. So the DMFC bipolar plate material and flow channel processing technique obtains more concerns. After introducing the bipolar plate structure and its functions, it points out that the bipolar plate material nowadays mainly involves the graphite materials, metals and composite. Then the corresponding preparation method, advantages and disadvantages of these three kinds of bipolar plate materials are analyzed. With the rapid development of Micro and Nano-technology and the demand for electricity supply of MEMS (Micro Electro Mechanical systems, micro-energy sources have been the focus, resulting in the miniaturization DMFC (μ DMFC). As the micro-bipolar plates has to survive the severe rugged working environment, such as high temperature, deep-etching, multi-field and alternating pressure), which challenges the material selection, flow channel configuration, processing method and precision. Therefore, hard-to-deform material such as titanium alloy is the preferred material for micro-bipolar plate. However, the new processing method has to be initialized for hard-to-deform material. This paper introduces the traditional and advanced processing methods of μDMFC bipolar plate. The existing problems of the DMFC bipolar plate material selection and processing are analyzed. We initialized one new technique that combines the laser-assisted heating method and micro die-pressing. The

  3. Bipolar Neutrosophic Refined Sets and Their Applications in Medical Diagnosis

    OpenAIRE

    Deli, Irfan; Yusuf, Şubaş

    2016-01-01

    This paper proposes concept of bipolar neutrosophic refined set and its some operations. Firstly, a score certainty and accuracy function to compare the bipolar neutrosophic refined information is defined. Secondly, to aggregate the bipolar neutrosophic refined information, a bipolar neutrosophic refined weighted average operator and a bipolar neutrosophic refined weighted geometric operator is developed.

  4. Commentary on the study: impact of depressive symptoms on future alcohol use in patients with co-occurring bipolar disorder and alcohol dependence: a prospective analysis in an 8-week randomized controlled trial of acamprosate (Prisciandaro et al.).

    Science.gov (United States)

    Preuss, Ulrich W

    2012-06-01

    Comorbidity of alcohol abuse and dependence with bipolar disorders is high. The aim of this short commentary is to review a current study investigating the impact of depressive symptoms and craving on alcohol use in individuals with co-occurring bipolar disorder and alcohol dependence. The strengths of Prisciandaro and colleagues' (2012) study are reviewed. The research group collected data as part of an 8-week, randomized, double-blind, placebo-controlled trial of acamprosate treatment in comorbid individuals. The importance of the study lies in highlighting the complex relationship between bipolar affective disorder symptoms, in particular depression, and alcohol use in a prospective design. It also overcomes several shortcomings of previous studies, since trajectories of both disorders within a short time frame of 1 week were hitherto rarely investigated. While the current study is successfully shedding light on the relationship between depressive symptoms, craving, and alcohol use in comorbid individuals, future studies may also investigate the influence of rapid cycling, mixed states, and psychotic symptoms on alcohol consumption and vice versa. Further, other comorbid samples could be included like first episode versus subjects with multiple affective episodes or comorbidity in males versus females. This research may provide a better basis for future psychotherapy and pharmacotherapy or integrated treatment approaches in these comorbid and severely affected individuals. Copyright © 2012 by the Research Society on Alcoholism.

  5. Relational memory in psychotic bipolar disorder

    Science.gov (United States)

    Sheffield, Julia M; Williams, Lisa E; Cohen, Neal; Heckers, Stephan

    2012-01-01

    Objectives Recent research has highlighted the phenotypic and genetic overlap of bipolar disorder and schizophrenia. Cognitive deficits in bipolar disorder parallel those seen in schizophrenia, particularly for bipolar disorder patients with a history of psychotic features. Here we explored whether relational memory deficits, which are prominent in schizophrenia, are also present in patients with psychotic bipolar disorder. Methods We tested 25 patients with psychotic bipolar disorder on a relational memory paradigm previously employed to quantify deficits in schizophrenia. During the training, participants learned to associate a set of faces and background scenes. During the testing, participants viewed a single background overlaid by three trained faces and were asked to recall the matching face, which was either present (Match trials) or absent (Non-Match trials). Explicit recognition and eye-movement data were collected and compared to 28 schizophrenia patients and 27 healthy subjects from a previously published dataset. Results Contrary to our prediction, we found psychotic bipolar disorder patients were less impaired in relational memory than schizophrenia subjects. Bipolar disorder subjects showed eye-movement behavior similar to healthy controls, whereas schizophrenia subjects were impaired relative to both groups. However, bipolar disorder patients with current delusions and/or hallucinations were more impaired than bipolar disorder patients not currently experiencing these symptoms. Conclusions We found that patients with psychotic bipolar disorder had better relational memory performance than schizophrenia patients, indicating that a history of psychotic symptoms does not lead to a significant relational memory deficit. PMID:22834462

  6. A rapid and robust assay for detection of S-phase cell cycle progression in plant cells and tissues by using ethynyl deoxyuridine

    Directory of Open Access Journals (Sweden)

    Horváth Gábor V

    2010-01-01

    Full Text Available Abstract Background Progress in plant cell cycle research is highly dependent on reliable methods for detection of cells replicating DNA. Frequency of S-phase cells (cells in DNA synthesis phase is a basic parameter in studies on the control of cell division cycle and the developmental events of plant cells. Here we extend the microscopy and flow cytometry applications of the recently developed EdU (5-ethynyl-2'-deoxyuridine-based S-phase assay to various plant species and tissues. We demonstrate that the presented protocols insure the improved preservation of cell and tissue structure and allow significant reduction in assay duration. In comparison with the frequently used detection of bromodeoxyuridine (BrdU and tritiated-thymidine incorporation, this new methodology offers several advantages as we discuss here. Results Applications of EdU-based S-phase assay in microscopy and flow cytometry are presented by using cultured cells of alfalfa, Arabidopsis, grape, maize, rice and tobacco. We present the advantages of EdU assay as compared to BrdU-based replication assay and demonstrate that EdU assay -which does not require plant cell wall digestion or DNA denaturation steps, offers reduced assay duration and better preservation of cellular, nuclear and chromosomal morphologies. We have also shown that fast and efficient EdU assay can also be an efficient tool for dual parameter flow cytometry analysis and for quantitative assessment of replication in thick root samples of rice. Conclusions In plant cell cycle studies, EdU-based S-phase detection offers a superior alternative to the existing S-phase assays. EdU method is reliable, versatile, fast, simple and non-radioactive and it can be readily applied to many different plant systems.

  7. Comparison of hemodynamic changes between old and very old patients undergoing cemented bipolar hemiarthroplasty under spinal anesthesia

    OpenAIRE

    Park, Hye Jin; Kang, Hyoseok; Lee, Jae-Woo; Baek, Seung Min; Seo, Jeong Seung

    2015-01-01

    Background The old age population, including the very old aged (? 85 years), is rapidly increasing, and femur neck fracture from accidents is commonly seen in the elderly. Use of bone cement during bipolar hemiarthroplasty can cause bone cement implantation syndrome. Methods This study was prospectively conducted on the elderly who were scheduled to undergo elective cemented bipolar hemiarthroplasty under spinal anesthesia. Patients were divided into 2 groups: the old age (65-84 years) and ve...

  8. Ultra-high resolution pollen record from the northern Andes reveals rapid shifts in montane climates within the last two glacial cycles

    Directory of Open Access Journals (Sweden)

    M. H. M. Groot

    2011-03-01

    Full Text Available Here we developed a composite pollen-based record of altitudinal vegetation changes from Lake Fúquene (5° N in Colombia at 2540 m elevation. We quantitatively calibrated Arboreal Pollen percentages (AP% into mean annual temperature (MAT changes with an unprecedented ~60-year resolution over the past 284 000 years. An age model for the AP% record was constructed using frequency analysis in the depth domain and tuning of the distinct obliquity-related variations to the latest marine oxygen isotope stacked record. The reconstructed MAT record largely concurs with the ~100 and 41-kyr (obliquity paced glacial cycles and is superimposed by extreme changes of up to 7 to 10° Celsius within a few hundred years at the major glacial terminations and during marine isotope stage 3, suggesting an unprecedented North Atlantic – equatorial link. Using intermediate complexity transient climate modelling experiments, we demonstrate that ice volume and greenhouse gasses are the major forcing agents causing the orbital-related MAT changes, while direct precession-induced insolation changes had no significant impact on the high mountain vegetation during the last two glacial cycles.

  9. Disease-associated CAG·CTG triplet repeats expand rapidly in non-dividing mouse cells, but cell cycle arrest is insufficient to drive expansion.

    Science.gov (United States)

    Gomes-Pereira, Mário; Hilley, James D; Morales, Fernando; Adam, Berit; James, Helen E; Monckton, Darren G

    2014-06-01

    Genetically unstable expanded CAG·CTG trinucleotide repeats are causal in a number of human disorders, including Huntington disease and myotonic dystrophy type 1. It is still widely assumed that DNA polymerase slippage during replication plays an important role in the accumulation of expansions. Nevertheless, somatic mosaicism correlates poorly with the proliferative capacity of the tissue and rates of cell turnover, suggesting that expansions can occur in the absence of replication. We monitored CAG·CTG repeat instability in transgenic mouse cells arrested by chemical or genetic manipulation of the cell cycle and generated unequivocal evidence for the continuous accumulation of repeat expansions in non-dividing cells. Importantly, the rates of expansion in non-dividing cells were at least as high as those of proliferating cells. These data are consistent with a major role for cell division-independent expansion in generating somatic mosaicism in vivo. Although expansions can accrue in non-dividing cells, we also show that cell cycle arrest is not sufficient to drive instability, implicating other factors as the key regulators of tissue-specific instability. Our data reveal that de novo expansion events are not limited to S-phase and further support a cell division-independent mutational pathway. © The Author(s) 2014. Published by Oxford University Press on behalf of Nucleic Acids Research.

  10. Bipolar polygenic loading and bipolar spectrum features in major depressive disorder

    NARCIS (Netherlands)

    Wiste, A.; Robinson, E.B.; Milaneschi, Y.; Meier, S.; Ripke, S.; Clements, C.C.; Fitzmaurice, G.M.; Rietschel, M.; Penninx, B.W.; Smoller, J.W.; Perlis, R.H.

    2014-01-01

    Objectives: Family and genetic studies indicate overlapping liability for major depressive disorder and bipolar disorder. The purpose of the present study was to determine whether this shared genetic liability influences clinical presentation. Methods: A polygenic risk score for bipolar disorder,

  11. Bipolar polygenic loading and bipolar spectrum features in major depressive disorder

    NARCIS (Netherlands)

    Wiste, Anna; Robinson, Elise B.; Milaneschi, Yuri; Meier, Sandra; Ripke, Stephan; Clements, Caitlin C.; Fitzmaurice, Garrett M.; Rietschel, Marcella; Penninx, Brenda W.; Smoller, Jordan W.; Perlis, Roy H.

    Objectives Family and genetic studies indicate overlapping liability for major depressive disorder and bipolar disorder. The purpose of the present study was to determine whether this shared genetic liability influences clinical presentation. Methods A polygenic risk score for bipolar disorder,

  12. Novel Concepts of Bipolar Fuzzy BCK-Submodules

    Directory of Open Access Journals (Sweden)

    M. A. Alghamdi

    2017-01-01

    Full Text Available Translations and multiplications of bipolar fuzzy BCK-submodules are discussed. Extensions of bipolar fuzzy BCK-submodules are introduced. Relations between translations and multiplications of bipolar fuzzy BCK-submodules are presented.

  13. An Introduction to Bipolar Single Valued Neutrosophic Graph Theory

    OpenAIRE

    Said Broumi; Florentin Smarandache; Mohamed Talea; Assia Bakali

    2016-01-01

    In this paper, we first define the concept of bipolar single neutrosophic graphs as the generalization of bipolar fuzzy graphs, N-graphs, intuitionistic fuzzy graph, single valued neutrosophic graphs and bipolar intuitionistic fuzzy graphs.

  14. Internet use by patients with bipolar disorder

    DEFF Research Database (Denmark)

    Bauer, Rita; Conell, Jörn; Glenn, Tasha

    2016-01-01

    There is considerable international interest in online education of patients with bipolar disorder, yet little understanding of how patients use the Internet and other sources to seek information. 1171 patients with a diagnosis of bipolar disorder in 17 countries completed a paper-based, anonymous...... on bipolar disorder or 63% of the total sample. More years of education in relation to the country mean, and feeling very confident about managing life decreased the odds of seeking information on bipolar disorder online, while having attended support groups increased the odds. Patients who looked online...... for information on bipolar disorder consulted medical professionals plus a mean of 2.3 other information sources such as books, physician handouts, and others with bipolar disorder. Patients not using the Internet consulted medical professionals plus a mean of 1.6 other information sources. The percentage...

  15. The common bipolar phenotype in young people

    OpenAIRE

    Rock, Philippa L; Chandler, Rebecca A.; Harmer, Catherine J.; Rogers, Robert D.; Goodwin, Guy M

    2013-01-01

    Background Mood elevation is common in adolescents and young adults. The aim of this study was to investigate the prevalence of a bipolar diagnosis and co-morbidity in individuals identified by online screening for experience of (hypo)manic symptoms in order to better define the common bipolar phenotype in young people. Methods Survey data regarding experience of (hypo)manic symptoms and occurrence of co-morbidities were analysed for 106 students satisfying criteria for probable bipolar syndr...

  16. Course of Subthreshold Bipolar Disorder in Youth: Diagnostic Progression from Bipolar Disorder Not Otherwise Specified

    Science.gov (United States)

    Axelson, David A.; Birmaher, Boris; Strober, Michael A.; Goldstein, Benjamin I.; Ha, Wonho; Gill, Mary Kay; Goldstein, Tina R.; Yen, Shirley; Hower, Heather; Hunt, Jeffrey I.; Liao, Fangzi; Iyengar, Satish; Dickstein, Daniel; Kim, Eunice; Ryan, Neal D.; Frankel, Erica; Keller, Martin B.

    2011-01-01

    Objective: To determine the rate of diagnostic conversion from an operationalized diagnosis of bipolar disorder not otherwise specified (BP-NOS) to bipolar I disorder (BP-I) or bipolar II disorder (BP-II) in youth over prospective follow-up and to identify factors associated with conversion. Method: Subjects were 140 children and adolescents…

  17. Nicotine dependence and psychosis in Bipolar disorder and Schizoaffective disorder, Bipolar type.

    Science.gov (United States)

    Estrada, Elena; Hartz, Sarah M; Tran, Jeffrey; Hilty, Donald M; Sklar, Pamela; Smoller, Jordan W; Pato, Michele T; Pato, Carlos N

    2016-06-01

    Patients with Bipolar disorder smoke more than the general population. Smoking negatively impacts mortality and clinical course in Bipolar disorder patients. Prior studies have shown contradictory results regarding the impact of psychosis on smoking behavior in Bipolar disorder. We analyzed a large sample of Bipolar disorder and Schizoaffective disorder, Bipolar Type patients and predicted those with a history of psychosis would be more likely to be nicotine dependent. Data from subjects and controls were collected from the Genomic Psychiatry Cohort (GPC). Subjects were diagnosed with Bipolar disorder without psychosis (N = 610), Bipolar disorder with psychosis (N = 1544). Participants were classified with or without nicotine dependence. Diagnostic groups were compared to controls (N = 10065) using logistic regression. Among smokers (N = 6157), those with Bipolar disorder had an increased risk of nicotine dependence (OR = 2.5; P disorder with psychosis were more likely to be dependent than Bipolar disorder patients without psychosis (OR = 1.3; P = 0.03). Schizoaffective disorder, Bipolar Type patients had more risk of nicotine dependence when compared to Bipolar disorder patients with or without psychosis (OR = 1.2; P = 0.02). Bipolar disorder patients experiencing more severity of psychosis have more risk of nicotine dependence. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

  18. Unsplit bipolar pulse forming line

    Science.gov (United States)

    Rhodes, Mark A [Pleasanton, CA

    2011-05-24

    A bipolar pulse forming transmission line module and system for linear induction accelerators having first, second, third, and fourth planar conductors which form a sequentially arranged interleaved stack having opposing first and second ends, with dielectric layers between the conductors. The first and second planar conductors are connected to each other at the first end, and the first and fourth planar conductors are connected to each other at the second end via a shorting plate. The third planar conductor is electrically connectable to a high voltage source, and an internal switch functions to short at the first end a high voltage from the third planar conductor to the fourth planar conductor to produce a bipolar pulse at the acceleration axis with a zero net time integral. Improved access to the switch is enabled by an aperture through the shorting plate and the proximity of the aperture to the switch.

  19. Development and testing of a bipolar lead-acid battery for hybrid electric vehicles

    Science.gov (United States)

    Saakes, Michel; Kluiters, Edwin; Schmal, Dick; Mourad, Salem; ten Have, Peter T. J. H.

    An 80 V bipolar lead-acid battery was constructed and tested using hybrid electric vehicle (HEV) drive cycles. Drive cycles with a peak power of 6.7 kW, equal to 1/5 of the total power profile required for the HEV studied, were run successfully. Model calculations showed that the 80 V module constructed, which is at the moment 2.5 times heavier than required for the HEV operation studied, can be optimised to meet the requirements.

  20. Virginia Woolf, neuroprogression, and bipolar disorder

    Directory of Open Access Journals (Sweden)

    Manuela V. Boeira

    2016-01-01

    Full Text Available Family history and traumatic experiences are factors linked to bipolar disorder. It is known that the lifetime risk of bipolar disorder in relatives of a bipolar proband are 5-10% for first degree relatives and 40-70% for monozygotic co-twins. It is also known that patients with early childhood trauma present earlier onset of bipolar disorder, increased number of manic episodes, and more suicide attempts. We have recently reported that childhood trauma partly mediates the effect of family history on bipolar disorder diagnosis. In light of these findings from the scientific literature, we reviewed the work of British writer Virginia Woolf, who allegedly suffered from bipolar disorder. Her disorder was strongly related to her family background. Moreover, Virginia Woolf was sexually molested by her half siblings for nine years. Her bipolar disorder symptoms presented a pernicious course, associated with hospitalizations, suicidal behavioral, and functional impairment. The concept of neuroprogression has been used to explain the clinical deterioration that takes places in a subgroup of bipolar disorder patients. The examination of Virgina Woolf’s biography and art can provide clinicians with important insights about the course of bipolar disorder.

  1. Virginia Woolf, neuroprogression, and bipolar disorder.

    Science.gov (United States)

    Boeira, Manuela V; Berni, Gabriela de Á; Passos, Ives C; Kauer-Sant'Anna, Márcia; Kapczinski, Flávio

    2017-01-01

    Family history and traumatic experiences are factors linked to bipolar disorder. It is known that the lifetime risk of bipolar disorder in relatives of a bipolar proband are 5-10% for first degree relatives and 40-70% for monozygotic co-twins. It is also known that patients with early childhood trauma present earlier onset of bipolar disorder, increased number of manic episodes, and more suicide attempts. We have recently reported that childhood trauma partly mediates the effect of family history on bipolar disorder diagnosis. In light of these findings from the scientific literature, we reviewed the work of British writer Virginia Woolf, who allegedly suffered from bipolar disorder. Her disorder was strongly related to her family background. Moreover, Virginia Woolf was sexually molested by her half siblings for nine years. Her bipolar disorder symptoms presented a pernicious course, associated with hospitalizations, suicidal behavioral, and functional impairment. The concept of neuroprogression has been used to explain the clinical deterioration that takes places in a subgroup of bipolar disorder patients. The examination of Virgina Woolf's biography and art can provide clinicians with important insights about the course of bipolar disorder.

  2. Bipolar Disorder and Obsessive Compulsive Disorder Comorbidity

    Directory of Open Access Journals (Sweden)

    Necla Keskin

    2014-08-01

    Full Text Available The comorbidity of bipolar disorder and anxiety disorders is a well known concept. Obsessive-compulsive disorder is the most commonly seen comorbid anxiety disorder in bipolar patients. Some genetic variants, neurotransmitters especially serotonergic systems and second-messenger systems are thought to be responsible for its etiology. Bipolar disorder alters the clinical aspects of obsessive compulsive disorder and is associated with poorer outcome. The determination of comorbidity between bipolar disorder and obsessive compulsive disorder is quite important for appropriate clinical management and treatment. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2014; 6(4.000: 429-437

  3. Late Onset Bipolar Disorder: Case Report

    Directory of Open Access Journals (Sweden)

    Filipa Araújo

    2016-07-01

    Full Text Available Background: Bipolar disorder affects approximately 1% of the population, with diagnosis often being made during late adolescence and early adulthood, and only rarely (0.1% in the elderly. Late onset bipolar disorder in the elderly has a impact on the nature and course of bipolar disorder. Aims: The authors report a case of bipolar disorder emerging in late life  (76years old with no cleary identified organic cause. Conclusion: This case highlights the importance of a broad differential diagnosis and pharmacologic management when approaching new-onset manic/depressive symptoms among geriatric patients.

  4. Dysfunctional gaze processing in bipolar disorder

    Directory of Open Access Journals (Sweden)

    Cristina Berchio

    2017-01-01

    The present study provides neurophysiological evidence for abnormal gaze processing in BP and suggests dysfunctional processing of direct eye contact as a prominent characteristic of bipolar disorder.

  5. Bipolar disorder and social work practice.

    Science.gov (United States)

    Sands, R G

    1985-01-01

    With the introduction of lithium and increasing evidence that bipolar disorder is a biogenetic condition, changes have occurred in the diagnosis and treatment of bipolar disorder. Cross-cultural studies indicate that in the United States there is a tendency to overuse the diagnosis of schizophrenia when bipolar may be indicated. Both disorders have psychotic symptoms, rendering diagnostic confusion possible. This paper describes the characteristics of bipolar disorder, explanatory theories and treatment. A medical model of treatment is preferred. Issues of concern to social workers are addressed.

  6. Stressful life events in older bipolar patients.

    Science.gov (United States)

    Beyer, John L; Kuchibhatla, Maragatha; Cassidy, Frederick; Krishnan, K Ranga R

    2008-12-01

    Theories about the impact of stressful life events (SLE) in bipolar disorder have focused on their role early in the disease. Few studies have examined SLE in older bipolar patients. We wanted to assess the impact of SLE in late life bipolar disorder We evaluated negative SLE experienced by older bipolar subjects compared with younger bipolar subjects and older controls for number, type, and their association with phase of illness, age of onset, and previous episodes. Both younger and older bipolar subjects have more SLE than similarly aged controls. There was no significant difference in the number of stressors that younger and older bipolar subjects experienced, based on mood state, previous episodes, or age-of-onset. Both older and younger depressed bipolar subjects reported more SLE in the previous 12 months compared with those in a manic state. Negative SLE are much more prevalent in bipolar patients compared with age-matched controls, and continue to be frequent in later life. (c) 2008 John Wiley & Sons, Ltd.

  7. Bipolar disorder: I. Temperament and character.

    Science.gov (United States)

    Engström, Christer; Brändström, Sven; Sigvardsson, Sören; Cloninger, Robert; Nylander, Per-Olof

    2004-10-01

    The nature of the relationship between personality and bipolar affective disorders is an important but unanswered question. We have studied personality in bipolar patients by using the Temperament and Character Inventory (TCI). TCI were administered to 100 euthymic bipolar patients and 100 controls from the normal population. Bipolar patients were significantly higher in harm avoidance (HA) and lower in reward dependence (RD), self-directedness (SD), and cooperativeness (CO) than controls. Bipolar patients are more fatigable, less sentimental, more independent, less purposeful, less resourceful, less empathic, less helpful, less pure-hearted, and have less impulse control than controls. Bipolar II patients are more impulsive, more fatigable, less resourceful, and have less impulse control than bipolar I patients. Our results are limited to euthymic bipolar patients and cannot be generalized to affective disorders. Even when clinically euthymic on lithium maintenance, bipolar patients continue to have a characteristic cognitive deficit. This is in agreement with cognitive theories about cognitive deficits in depression that are regarded as important vulnerability factors in mood disorders.

  8. [Psychosocial treatment of bipolar disorder].

    Science.gov (United States)

    Peña García, I; Martín Gómez, C; Santamaría, C; Sánchez Cubas, S; San Pedro, L; Lana Moliner, F

    1998-01-01

    The bipolar disorder is an important health problem. It presents with severe sintoms, and it tends to cronify. Although lithium has a prophilactic role, it has not controlled the development of severe psychosocial complications. It is necessary to study the psychosocial aspects related to this disorder, to define the areas in which the psychosocial interventions are needed, and the types of psychosocial approaches that can be useful. Review of the literature, through MEDLINE database in the last fifteen years, about psychosocial complications of bipolar disorder and its treatment. Many articles emphasize the important psychosocial deficits that appear in patients with bipolar disorder. These deficits concern to all social functions and persist for a long time. The patients are more vulnerable to stressing events, that can have devastating consecuences. The articles report the influence in the evolution and prognosis of this disorder, by the comorbidity of other medical and pschiatric problems. The psychotherapeutical interventions can be of interest to treat the social aspects that lithium fails to control. Our approach would tend to integrate in the clinical practice both, the biomedical and psychosocial theories. This permits an integral treatment of all the factors implicated in the genesis, maintenance, and consecuences of the mental disorders.

  9. Staging in bipolar disorder: from theoretical framework to clinical utility.

    Science.gov (United States)

    Berk, Michael; Post, Robert; Ratheesh, Aswin; Gliddon, Emma; Singh, Ajeet; Vieta, Eduard; Carvalho, Andre F; Ashton, Melanie M; Berk, Lesley; Cotton, Susan M; McGorry, Patrick D; Fernandes, Brisa S; Yatham, Lakshmi N; Dodd, Seetal

    2017-10-01

    Illness staging is widely utilized in several medical disciplines to help predict course or prognosis, and optimize treatment. Staging models in psychiatry in general, and bipolar disorder in particular, depend on the premise that psychopathology moves along a predictable path: an at-risk or latency stage, a prodrome progressing to a first clinical threshold episode, and one or more recurrences with the potential to revert or progress to late or end-stage manifestations. The utility and validity of a staging model for bipolar disorder depend on its linking to clinical outcome, treatment response and neurobiological measures. These include progressive biochemical, neuroimaging and cognitive changes, and potentially stage-specific differences in response to pharmacological and psychosocial treatments. Mechanistically, staging models imply the presence of an active disease process that, if not remediated, can lead to neuroprogression, a more malignant disease course and functional deterioration. Biological elements thought to be operative in bipolar disorder include a genetic diathesis, physical and psychic trauma, epigenetic changes, altered neurogenesis and apoptosis, mitochondrial dysfunction, inflammation, and oxidative stress. Many available agents, such as lithium, have effects on these targets. Staging models also suggest the utility of stage-specific treatment approaches that may not only target symptom reduction, but also impede illness neuroprogression. These treatment approaches range from prevention for at-risk individuals, to early intervention strategies for prodromal and newly diagnosed individuals, complex combination therapy for rapidly recurrent illness, and palliative-type approaches for those at chronic, late stages of illness. There is hope that prompt initiation of potentially disease modifying therapies may preclude or attenuate the cognitive and structural changes seen in the later stages of bipolar disorder. The aims of this paper are to: a

  10. Staging in bipolar disorder: from theoretical framework to clinical utility

    Science.gov (United States)

    Berk, Michael; Post, Robert; Ratheesh, Aswin; Gliddon, Emma; Singh, Ajeet; Vieta, Eduard; Carvalho, Andre F.; Ashton, Melanie M.; Berk, Lesley; Cotton, Susan M.; McGorry, Patrick D.; Fernandes, Brisa S.; Yatham, Lakshmi N.; Dodd, Seetal

    2017-01-01

    Illness staging is widely utilized in several medical disciplines to help predict course or prognosis, and optimize treatment. Staging models in psychiatry in general, and bipolar disorder in particular, depend on the premise that psychopathology moves along a predictable path: an at‐risk or latency stage, a prodrome progressing to a first clinical threshold episode, and one or more recurrences with the potential to revert or progress to late or end‐stage manifestations. The utility and validity of a staging model for bipolar disorder depend on its linking to clinical outcome, treatment response and neurobiological measures. These include progressive biochemical, neuroimaging and cognitive changes, and potentially stage‐specific differences in response to pharmacological and psychosocial treatments. Mechanistically, staging models imply the presence of an active disease process that, if not remediated, can lead to neuroprogression, a more malignant disease course and functional deterioration. Biological elements thought to be operative in bipolar disorder include a genetic diathesis, physical and psychic trauma, epigenetic changes, altered neurogenesis and apoptosis, mitochondrial dysfunction, inflammation, and oxidative stress. Many available agents, such as lithium, have effects on these targets. Staging models also suggest the utility of stage‐specific treatment approaches that may not only target symptom reduction, but also impede illness neuroprogression. These treatment approaches range from prevention for at‐risk individuals, to early intervention strategies for prodromal and newly diagnosed individuals, complex combination therapy for rapidly recurrent illness, and palliative‐type approaches for those at chronic, late stages of illness. There is hope that prompt initiation of potentially disease modifying therapies may preclude or attenuate the cognitive and structural changes seen in the later stages of bipolar disorder. The aims of this paper

  11. Functional Outcome in Bipolar Disorder: The Big Picture

    Directory of Open Access Journals (Sweden)

    Boaz Levy

    2012-01-01

    Full Text Available Previous research on functional outcome in bipolar disorder (BD has uncovered various factors that exacerbate psychosocial disability over the course of illness, including genetics, illness severity, stress, anxiety, and cognitive impairment. This paper presents an integrated view of these findings that accounts for the precipitous decline in psychosocial functioning after illness onset. The proposed model highlights a number of reciprocal pathways among previously studied factors that trap people in a powerful cycle of ailing forces. The paper discusses implications to patient care as well as the larger social changes required for shifting the functional trajectory of people with BD from psychosocial decline to growth.

  12. Bipolar disorders in the Arab world: a critical review.

    Science.gov (United States)

    Kronfol, Ziad; Zakaria Khalil, Mostafa; Kumar, Pankaj; Suhre, Karsten; Karam, Elie; McInnis, Melvin

    2015-05-01

    Bipolar disorders are common psychiatric disorders that affect 1-5% of the population worldwide. Major advances in the epidemiology, pathophysiology, and treatment of the disorders have recently occurred. The majority of published reports, however, originate from the Western hemisphere, mostly Europe and the United States. There is a shortage of data from the Arab world on bipolar disorders. In an era of globalization and rapid communication, it is not clear to what extent research findings pertaining to one part of the world are by necessity applicable to other parts. Psychiatric disorders are known to be affected by the culture in which they occur, and knowledge of variations in illness presentation in different ethnic groups is also increasing. However, knowledge of variations affecting Arab populations remains quite limited. This paper provides a critical review of the literature on bipolar affective disorders in the Arab world, pointing to major gaps in knowledge and future opportunities to fill these gaps. © 2015 New York Academy of Sciences.

  13. Bipolar lead-acid battery for hybrid vehicles

    Science.gov (United States)

    Saakes, M.; Woortmeijer, R.; Schmal, D.

    Within the framework of the European project bipolar lead-acid power source (BILAPS), a new production route is being developed for the bipolar lead-acid battery. The performance targets are 500 W kg -1, 30 Wh kg -1 and 100 000 power-assist life cycles (PALCs). The operation voltage of the battery can be, according to the requirements, 12, 36 V or any other voltage. Tests with recently developed 4 and 12 V prototypes, each of 30 Ah capacity have demonstrated that the PALC can be operated using 10 C discharge and 9 C charge peaks. The tests show no overvoltage or undervoltage problems during three successive test periods of 16 h with 8 h rest in between. The temperature stabilizes during these tests at 40-45 °C using a thermal-management system. The bipolar lead acid battery is operated at an initial 50% state-of-charge. During the tests, the individual cell voltages display only very small differences. Tests are now in progress to improve further the battery-management system, which has been developed at the cell level, during the period no PALCs are run in order to improve the hybrid behaviour of the battery. The successful tests show the feasibility of operating the bipolar lead-acid battery in a hybrid mode. The costs of the system are estimated to be much lower than those for nickel-metal-hydride or Li-ion based high-power systems. An additional advantage of the lead-acid system is that recycling of lead-acid batteries is well established.

  14. Bipolar mixed features - Results from the comparative effectiveness for bipolar disorder (Bipolar CHOICE) study.

    Science.gov (United States)

    Tohen, Mauricio; Gold, Alexandra K; Sylvia, Louisa G; Montana, Rebecca E; McElroy, Susan L; Thase, Michael E; Rabideau, Dustin J; Nierenberg, Andrew A; Reilly-Harrington, Noreen A; Friedman, Edward S; Shelton, Richard C; Bowden, Charles L; Singh, Vivek; Deckersbach, Thilo; Ketter, Terence A; Calabrese, Joseph R; Bobo, William V; McInnis, Melvin G

    2017-08-01

    DSM-5 changed the criteria from DSM-IV for mixed features in mood disorder episodes to include non-overlapping symptoms of depression and hypomania/mania. It is unknown if, by changing these criteria, the same group would qualify for mixed features. We assessed how those meeting DSM-5 criteria for mixed features compare to those meeting DSM-IV criteria. We analyzed data from 482 adult bipolar patients in Bipolar CHOICE, a randomized comparative effectiveness trial. Bipolar diagnoses were confirmed through the MINI International Neuropsychiatric Interview (MINI). Presence and severity of mood symptoms were collected with the Bipolar Inventory of Symptoms Scale (BISS) and linked to DSM-5 and DSM-IV mixed features criteria. Baseline demographics and clinical variables were compared between mood episode groups using ANOVA for continuous variables and chi-square tests for categorical variables. At baseline, the frequency of DSM-IV mixed episodes diagnoses obtained with the MINI was 17% and with the BISS was 20%. Using DSM-5 criteria, 9% of participants met criteria for hypomania/mania with mixed features and 12% met criteria for a depressive episode with mixed features. Symptom severity was also associated with increased mixed features with a high rate of mixed features in patients with mania/hypomania (63.8%) relative to those with depression (8.0%). Data on mixed features were collected at baseline only and thus do not reflect potential patterns in mixed features within this sample across the study duration. The DSM-5 narrower, non-overlapping definition of mixed episodes resulted in fewer patients who met mixed criteria compared to DSM-IV. Copyright © 2017. Published by Elsevier B.V.

  15. Mixed States in Bipolar Disorder: Etiology, Pathogenesis and Treatment

    Science.gov (United States)

    2017-01-01

    Many bipolar disorder patients exhibit mixed affective states, which portend a generally more severe illness course and treatment resistance. In the previous renditions of Diagnostic and Statistical Manual mixed states were narrowly defined in the context of bipolar I disorder, but with the advent of DSM-5 the term “mixed episode” was dropped and replaced by “mixed features” specifier which could be broadly applied to manic, hypomanic and depressive episodes in both the bipolar spectrum and major depressive disorders. This paradigm shift reflected their significance in the prognosis and overall management of mood disorders, so that the clinicians should thoroughly familiarize themselves with the contemporary notions surrounding these conditions. The purpose of this manuscript is to bring to light the current conceptualizations regarding the etiology, pathogenesis and treatment of mixed states. To achieve this goal, in June 2016 an extensive literature search was undertaken using the PubMed database. Some exploratory terms utilized included “mixed states”, “mixed episodes”, “switching”, “rapid cycling” cross referenced with “bipolar disorder”. Focusing on the most relevant and up to date studies, it was revealed that mixed states result from genetic susceptibility in the circadian and dopamine neurotransmission apparatuses and disturbance in the intricate catecholamine-acetylcholine neurotransmission balance which leads to mood fluctuations. The management of mixed states is challenging with atypical antipsychotics, newer anticonvulsants and electroconvulsive therapy emerging as the foremost treatment options. In conclusion, while progress has been made in the neurobiological understanding of mixed states, the currently available therapeutic modalities have only shown limited effectiveness. PMID:28184334

  16. Up-cycling waste glass to minimal water adsorption/absorption lightweight aggregate by rapid low temperature sintering: optimization by dual process-mixture response surface methodology.

    Science.gov (United States)

    Velis, Costas A; Franco-Salinas, Claudia; O'Sullivan, Catherine; Najorka, Jens; Boccaccini, Aldo R; Cheeseman, Christopher R

    2014-07-01

    Mixed color waste glass extracted from municipal solid waste is either not recycled, in which case it is an environmental and financial liability, or it is used in relatively low value applications such as normal weight aggregate. Here, we report on converting it into a novel glass-ceramic lightweight aggregate (LWA), potentially suitable for high added value applications in structural concrete (upcycling). The artificial LWA particles were formed by rapidly sintering (glass powder with clay mixes using sodium silicate as binder and borate salt as flux. Composition and processing were optimized using response surface methodology (RSM) modeling, and specifically (i) a combined process-mixture dual RSM, and (ii) multiobjective optimization functions. The optimization considered raw materials and energy costs. Mineralogical and physical transformations occur during sintering and a cellular vesicular glass-ceramic composite microstructure is formed, with strong correlations existing between bloating/shrinkage during sintering, density and water adsorption/absorption. The diametrical expansion could be effectively modeled via the RSM and controlled to meet a wide range of specifications; here we optimized for LWA structural concrete. The optimally designed LWA is sintered in comparatively low temperatures (825-835 °C), thus potentially saving costs and lowering emissions; it had exceptionally low water adsorption/absorption (6.1-7.2% w/wd; optimization target: 1.5-7.5% w/wd); while remaining substantially lightweight (density: 1.24-1.28 g.cm(-3); target: 0.9-1.3 g.cm(-3)). This is a considerable advancement for designing effective environmentally friendly lightweight concrete constructions, and boosting resource efficiency of waste glass flows.

  17. Suicide attempts in bipolar I patients: impact of comorbid personality disorders

    Directory of Open Access Journals (Sweden)

    Severino Bezerra Filho

    Full Text Available Objective: To evaluate the association between personality disorders (PDs and suicide attempts (SAs in euthymic patients with type I bipolar disorder (BD. Methods: One-hundred twenty patients with type I BD, with and without history of SA, were evaluated during euthymia. The assessment included a clinical and sociodemographic questionnaire, the Hamilton Depression Rating Scale, the Young Mania Rating Scale, the Barratt Impulsiveness Scale, and Structured Clinical Interviews for DSM-IV Axis I and II Disorders. Logistic regression was employed to determine associations between history of SA and patient characteristics. Results: History of SA was significantly associated with comorbid axis I disorder, rapid cycling, high impulsivity (attentional, motor, non-planning, and total, having any PD, and cluster B and C PDs. Only cluster B PDs, high attentional impulsivity, and lack of paid occupation remained significant after multivariate analysis. Conclusions: Cluster B PDs were significantly associated with SA in patients with type I BD. High attentional impulsivity and lack of gainful employment were also associated with SA, which suggests that some cluster B clinical and social characteristics may exacerbate suicidal behavior in this population. This finding offers alternatives for new therapeutic interventions.

  18. Childhood trauma, dimensions of psychopathology and the clinical expression of bipolar disorders: A pathway analysis.

    Science.gov (United States)

    Etain, B; Lajnef, M; Henry, C; Aubin, V; Azorin, J M; Bellivier, F; Bougerol, T; Courtet, P; Gard, S; Kahn, J P; Passerieux, C; Leboyer, M

    2017-12-01

    This study aims at testing for paths from childhood abuse to clinical indicators of complexity in bipolar disorder (BD), through dimensions of affective dysregulation, impulsivity and hostility. 485 euthymic patients with BD from the FACE-BD cohort were included from 2009 to 2014. We collect clinical indicators of complexity/severity: age and polarity at onset, suicide attempt, rapid cycling and substance misuse. Patients completed questionnaires to assess childhood emotional, sexual and physical abuses, affective lability, affect intensity, impulsivity, motor and attitudinal hostility. The path-analysis demonstrated significant associations between emotional abuse and all the affective/impulsive dimensions (p < 0.001). Sexual abuse was moderately associated with emotion-related dimensions but not with impulsivity nor motor hostility. In turn, affect intensity and attitudinal hostility were associated with high risk for lifetime presence of suicide attempts (p < 0.001), whereas impulsivity was associated with a higher risk of lifetime presence of substance misuse (p < 0.001). No major additional paths were identified when including Emotional and Physical Neglect in the model. This study provides refinement of the links between early adversity, dimensions of psychopathology and the complexity/severity of BD. Mainly, dimensions of affective dysregulation, impulsivity/hostility partially mediate the links between childhood emotional to suicide attempts and substance misuse in BD. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. Glassy carbon supercapacitor: 100,000 cycles demonstrated

    Energy Technology Data Exchange (ETDEWEB)

    Baertsch, M.; Braun, A.; Schnyder, B.; Koetz, R. [Paul Scherrer Inst. (PSI), Villigen (Switzerland)

    1999-08-01

    A 5 V glassy carbon capacitor stack was built consisting of four bipolar and two end-plate electrodes. More than 100,000 charging/discharging cycles were applied to test the stability of the double-layer capacitor. Low and high frequency resistances were measured as a function of the number of cycles. (author) 2 figs., 1 ref.

  20. The International College of Neuropsychopharmacology (CINP) Treatment Guidelines for Bipolar Disorder in Adults (CINP-BD-2017), Part 1: Background and Methods of the Development of Guidelines

    Science.gov (United States)

    Young, Allan; Yatham, Lakshmi; Grunze, Heinz; Vieta, Eduard; Blier, Pierre; Moeller, Hans Jurgen; Kasper, Siegfried

    2017-01-01

    Abstract Background: This paper includes a short description of the important clinical aspects of Bipolar Disorder with emphasis on issues that are important for the therapeutic considerations, including mixed and psychotic features, predominant polarity, and rapid cycling as well as comorbidity. Methods: The workgroup performed a review and critical analysis of the literature concerning grading methods and methods for the development of guidelines. Results: The workgroup arrived at a consensus to base the development of the guideline on randomized controlled trials and related meta-analyses alone in order to follow a strict evidence-based approach. A critical analysis of the existing methods for the grading of treatment options was followed by the development of a new grading method to arrive at efficacy and recommendation levels after the analysis of 32 distinct scenarios of available data for a given treatment option. Conclusion: The current paper reports details on the design, method, and process for the development of CINP guidelines for the treatment of Bipolar Disorder. The rationale and the method with which all data and opinions are combined in order to produce an evidence-based operationalized but also user-friendly guideline and a specific algorithm are described in detail in this paper. PMID:27815414

  1. Energy Band Diagram near the Interface of Aluminum Oxide on p-Si Fabricated by Atomic Layer Deposition without/with Rapid Thermal Cycle Annealing Determined by Capacitance-Voltage Measurements

    Energy Technology Data Exchange (ETDEWEB)

    Satoh, N. [Department of Electrical Engineering, Kyoto University, Kyoto (Japan); Cesar, I.; Lamers, M.; Romijn, I.; Bakker, K.; Olson, C.; Oosterling Saynova, D.; Komatsu, Y.; Weeber, A. [ECN Solar Energy, Petten (Netherlands); Verbake, F.; Wiggers, M. [Philips Research, Eindhoven (Netherlands)

    2012-07-01

    We evaluated the fixed charge (Qf) and the interface state density (Dit) from the capacitance-voltage (C-V) measurement before and after rapid thermal cycle annealing (RTCA) using p-type silicon in which the passivation was performed with aluminum oxide (Al2O3) film by atomic layer deposition (ALD). From C-V measurement we obtained the surface potential (VS), accumulation and depletion width, and as a result, energy band diagrams were produced. It was determined that a barrier height of approximately 100 mV was induced by fixed negative charges in the Al2O3 layer near the interface to the p-type Si substrate. The field effect of the Al2O3 passivation layer created by RTCA strongly remains without depending on the gate voltage (VG)

  2. Developmental staging models in bipolar disorder

    OpenAIRE

    Passos,Ives C.; Jansen, Karen; Kapczinski,Flavio

    2015-01-01

    The previous contribution of Duffy and colleagues suggests that a chain of behavioral events starting during childhood precedes the development of full-blown bipolar disorder. In this vein, the recent contribution of Keown-Stoneman and colleagues brings a new perspective to the study of prodromal symptoms of bipolar disorder.

  3. Stochastic Charge Fluctuations in Bipolar Electrodes

    NARCIS (Netherlands)

    Kostiuchenko, Zinaida; Zhang, B.; Lemay, Serge Joseph Guy

    2016-01-01

    Bipolar electrodes provide a powerful and versatile means of coupling two or more spatially separated electrochemical reactions. While normally described in terms of macroscopic rate equations, the ongoing drive toward the miniaturization of bipolar electrodes means that new regimes are becoming

  4. Perceived parental rearing of bipolar offspring

    NARCIS (Netherlands)

    Reichart, C. G.; van der Ende, J.; Hillegers, M. H. J.; Wals, M.; Bongers, I. L.; Nolen, W. A.; Ormel, J.; Verhulst, F. C.

    Objective: To explore the impact of growing up with a parent with a bipolar disorder. First, we compared parental rearing behavior perceived by young adult offspring of bipolar parents with parental rearing behavior perceived by same aged young adults from the general population. Secondly, we

  5. Swimming in Deep Water: Childhood Bipolar Disorder

    Science.gov (United States)

    Senokossoff, Gwyn W.; Stoddard, Kim

    2009-01-01

    The authors focused on one parent's struggles in finding a diagnosis and intervention for a child who had bipolar disorder. The authors explain the process of identification, diagnosis, and intervention of a child who had bipolar disorder. In addition to the personal story, the authors provide information on the disorder and outline strategies…

  6. Internet use by patients with bipolar disorder

    DEFF Research Database (Denmark)

    Bauer, Rita; Conell, Jörn; Glenn, Tasha

    2016-01-01

    There is considerable international interest in online education of patients with bipolar disorder, yet little understanding of how patients use the Internet and other sources to seek information. 1171 patients with a diagnosis of bipolar disorder in 17 countries completed a paper-based, anonymou...

  7. Heritability of bipolar affective disorder: Family study

    Directory of Open Access Journals (Sweden)

    Obradović Tanja

    2011-01-01

    Full Text Available Background/Aim. Bipolar affective disorder is mental disorder with polygenic type of heredity. Heritability - relation between genetic and environmental variance is used to estimate the level of influence of genetic variance to phenotype variance. Study results show decreasing trend in the value of heritability of bipolar affective disorder, thus indicating that this disorder is a complex behavioral threshold characteristic. Therefore, the aim of this study was to estimate the contribution of genetic variance to phenotype variance of bipolar affective disorder, i.e. to estimate heritability of this disorder. Methods. By the use of a questionnaire, 80 patients with over crossed threshold for bipolar affective disorder were asked for functional information about the members of their families belonging to the first degree of relation (fathers, mothers and full- sibs. By using ”Applet for calculating heritability for threshold traits (disease“, and regression analysis, heritability of bipolar affective disorder as well as its statistical significance, were estimated (χ2 test. Results. Heritability and relationship of genetic and environmental variance of bipolar affective disorder is 0.2 with statistically significant difference from zero (p < 0.001. Conclusion. The estimated contribution of genetic variance to phenotype variance of bipolar affective disorder is low being 20%, while the contribution of environmental variance is 80%. This result contributes to the understanding of bipolar affective disorder as a complex behavioral threshold trait.

  8. The prestige model of spectrum bipolarity.

    Science.gov (United States)

    Le Bas, James; Newton, Richard; Sore, Rachel; Castle, David

    2015-02-01

    Because affective pathogenesis is a hard problem for psychiatry, it behoves researchers to develop and test novel models of causality. We examine the notion that the adaptive drive to social investment - prestige - provides clues to the bipolar spectrum. A seven node bipolar spectrum is proposed, based on a putative gradient of "bipolarity". It is conceived that this gradient may correlate with the drive to social investment (prestige). In order to test this hypothesis with proof of concept data, a case control study categorised 228 subjects into a seven node bipolar spectrum. Whilst controlling for mood elevation and depression, differences in strategic prestige (leadership) motivation (MSPM) between spectrum groups were examined. The bipolar I (S1) node had a greater strategic prestige (leadership) motivation score than the controls (S7) by 21.17 points, 95% CI [8.16, 34.18], pleadership) motivation score positively correlated with dimensional lifetime bipolarity (Mood Disorder Questionnaire) score (rp=0.47), supporting the spectrum prestige motivation gradient notion. Evidence is presented for a genetic disposition to elevated strategic prestige (leadership) motivation. Sensitivity to Social Inclusion (MSIS), Contingency of Self-Worth (CSW.av) and tension significantly predicted strategic prestige (leadership) motivation (MSPM) score in a multiple regression. - suggesting that a vulnerability of the social self may be a feature of bipolar disorders. The prestige model of spectrum bipolarity offers a new conceptualisation of affective disorders and has received preliminary support. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. Subthreshold bipolarity: diagnostic issues and challenges.

    Science.gov (United States)

    Nusslock, Robin; Frank, Ellen

    2011-01-01

    Research suggests that current diagnostic criteria for bipolar disorders may fail to include milder, but clinically significant, bipolar syndromes and that a substantial percentage of these conditions are diagnosed, by default, as unipolar major depression. Accordingly, a number of researchers have argued for the upcoming 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to better account for subsyndromal hypomanic presentations. The present paper is a critical review of research on subthreshold bipolarity, and an assessment of some of the challenges that researchers and clinicians might face if the DSM-5 were designed to systematically document subsyndromal hypomanic presentations. Individuals with major depressive disorder (MDD) who display subsyndromal hypomanic features, not concurrent with a major depressive episode, have a more severe course compared to individuals with MDD and no hypomanic features, and more closely resemble individuals with bipolar disorder on a number of clinical validators. There are clinical and scientific reasons for systematically documenting subsyndromal hypomanic presentations in the assessment and diagnosis of mood disorders. However, these benefits are balanced with important challenges, including (i) the difficulty in reliably identifying subsyndromal hypomanic presentations, (ii) operationalizing subthreshold bipolarity, (iii) differentiating subthreshold bipolarity from borderline personality disorder, (iv) the risk of over-diagnosing bipolar spectrum disorders, and (v) uncertainties about optimal interventions for subthreshold bipolarity. © 2011 John Wiley and Sons A/S.

  10. NO signaling in retinal bipolar cells.

    Science.gov (United States)

    Agurto, A; Vielma, A H; Cadiz, B; Couve, E; Schmachtenberg, O

    2017-08-01

    Nitric oxide (NO) is a neuromodulator involved in physiological and pathological processes in the retina. In the inner retina, a subgroup of amacrine cells have been shown to synthesize NO, but bipolar cells remain controversial as NO sources. This study correlates NO synthesis in dark-adapted retinas, through labeling with the NO marker DAF-FM, with neuronal nitric oxide synthase (nNOS) and inducible NOS expression, and presence of the NO receptor soluble guanylate cyclase in bipolar cells. NO containing bipolar cells were morphologically identified by dialysis of DAF fluorescent cells with intracellular dyes, or by DAF labeling followed by immunohistochemistry for nNOS and other cellular markers. DAF fluorescence was observed in all types of bipolar cells that could be identified, but the most intense DAF fluorescence was observed in bipolar cells with severed processes, supporting pathological NO signaling. Among nNOS expressing bipolar cells, type 9 was confirmed unequivocally, while types 2, 3a, 3b, 4, 5, 7, 8 and the rod bipolar cell were devoid of this enzyme. These results establish specific bipolar cell types as NO sources in the inner retina, and support the involvement of NO signaling in physiological and pathological processes in the inner retina. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. 2017 Bipolar Plate Workshop Summary Report

    Energy Technology Data Exchange (ETDEWEB)

    Kopasz, John P. [Argonne National Lab. (ANL), Argonne, IL (United States); Benjamin, Thomas G. [Argonne National Lab. (ANL), Argonne, IL (United States); Schenck, Deanna [Argonne National Lab. (ANL), Argonne, IL (United States)

    2017-08-17

    The Bipolar Plate (BP) Workshop was held at USCAR1 in Southfield, Michigan on February 14, 2017 and included 63 participants from industry, government agencies, universities, and national laboratories with expertise in the relevant fields. The objective of the workshop was to identify research and development (R&D) needs, in particular early-stage R&D, for bipolar plates for polymer electrolyte membrane (PEM) fuel cells for transportation applications. The focus of the workshop was on materials, manufacturing, and design aspects of bipolar plates with the goal of meeting DOE’s 2020 bipolar plate targets. Of special interest was the cost target of ≤$3/kW for the bipolar plate.

  12. Integrating Bipolar Disorder Management in Primary Care

    Science.gov (United States)

    Kilbourne, Amy M.; Goodrich, David E.; O’Donnell, Allison N.; Miller, Christopher J.

    2012-01-01

    There is growing realization that persons with bipolar disorder may exclusively be seen in primary (general medical) care settings, notably because of limited access to mental health care and stigma in seeking mental health treatment. At least two clinical practice guidelines for bipolar disorder recommend collaborative chronic care models (CCMs) to help integrate mental health care to better manage this illness. CCMs, which include provider guideline support, self-management support, care management, and measurement-based care, are well-established in primary care settings, and may help primary care practitioners manage bipolar disorder. However, further research is required to adapt CCMs to support complexities in diagnosing persons with bipolar disorder, and integrate decision-making processes regarding medication safety and tolerability in primary care. Additional implementation studies are also needed to adapt CCMs for persons with bipolar disorder in primary care, especially those seen in smaller practices with limited infrastructure and access to mental health care. PMID:23001382

  13. Circadian preferences, oxidative stress and inflammatory cytokines in bipolar disorder: A community study.

    Science.gov (United States)

    Mondin, Thaise Campos; de Azevedo Cardoso, Taiane; Moreira, Fernanda Pedrotti; Wiener, Carolina; Oses, Jean Pierre; de Mattos Souza, Luciano Dias; Jansen, Karen; da Silva Magalhães, Pedro Vieira; Kapczinski, Flávio; da Silva, Ricardo Azevedo

    2016-12-15

    To assess circadian preference among a community sample of people with bipolar disorder, major depression and without any mood disorders. Secondly, we investigated the association of circadian preference with cytokines interleukin-6 (IL-6), interleukin-10 (IL-10) and, tumor necrosis factor alpha (TNF-α) and oxidative stress assessed by thiobarbituric acid reactive substances (TBARS), uric acid and Protein Carbonyl Content (PCC). A cross-sectional study nested in a population-based sample. Caseness was confirmed with the Structured Clinical Interview for DSM-IV. A sample of 215 participants, in whom we measured circadian preferences, IL-6, IL-10, TNF-α, TBARS, uric acid, PCC. Biological rhythms were evaluated using the Biological Interview of Assessment in Neuropsychiatry. Bipolar group presented a higher alteration in biological rhythms (40.40±9.78) when compared with the major depression group (36.35±9.18) and control group (27.61±6.89) pbipolar disorder who were active at night and had a day/night cycle reverse showed decreased levels of IL-6 (t, 44=2.096; p=0.042), (t, 44=2.213; p=0.032), respectively. In the bipolar disorder group subjects who presented day/night cycle reverse had lower TBARS levels (t, 41=2.612; p=0.013). TNF-α were decreased in subjects more active at night with bipolar disorder. Lower serum levels of IL-6, TNF-α and TBARS were associated with evening preference in bipolar disorder group. These findings suggest that chronotype may alter the levels of interleukins and oxidative stress levels in bipolar and healthy subjects. A better understanding of the role of circadian preferences in levels of interleukins and oxidative stress are needed. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. Bipolar Transistor Based on Graphane

    Energy Technology Data Exchange (ETDEWEB)

    Gharekhanlou, B; Tousaki, S B; Khorasani, S, E-mail: khorasani@sharif.ed [School of Electrical Engineering, Sharif University of Technology, PO Box 11365-9363, Tehran (Iran, Islamic Republic of)

    2010-11-01

    Graphane is a semiconductor with an energy gap, obtained from hydrogenation of the two-dimensional grapheme sheet. Together with the two-dimensional geometry, unique transport features of graphene, and possibility of doping graphane, p and n regions can be defined so that p-n junctions become feasible with small reverse currents. Our recent analysis has shown that an ideal I-V characteristic for this type of junctions may be expected. Here, we predict the behavior of bipolar juncrion transistors based on graphane. Profiles of carriers and intrinsic parameters of the graphane transistor are calculated and discussed.

  15. The catecholaminergic-cholinergic balance hypothesis of bipolar disorder revisited

    Science.gov (United States)

    van Enkhuizen, Jordy; Janowsky, David S; Olivier, Berend; Minassian, Arpi; Perry, William; Young, Jared W; Geyer, Mark A

    2014-01-01

    Bipolar disorder is a unique illness characterized by fluctuations between mood states of depression and mania. Originally, an adrenergic-cholinergic balance hypothesis was postulated to underlie these different affective states. In this review, we update this hypothesis with recent findings from human and animal studies, suggesting that a catecholaminergic-cholinergic hypothesis may be more relevant. Evidence from neuroimaging studies, neuropharmacological interventions, and genetic associations support the notion that increased cholinergic functioning underlies depression, whereas increased activations of the catecholamines (dopamine and norepinephrine) underlie mania. Elevated functional acetylcholine during depression may affect both muscarinic and nicotinic acetylcholine receptors in a compensatory fashion. Increased functional dopamine and norepinephrine during mania on the other hand may affect receptor expression and functioning of dopamine reuptake transporters. Despite increasing evidence supporting this hypothesis, a relationship between these two neurotransmitter systems that could explain cycling between states of depression and mania is missing. Future studies should focus on the influence of environmental stimuli and genetic susceptibilities that may affect the catecholaminergic-cholinergic balance underlying cycling between the affective states. Overall, observations from recent studies add important data to this revised balance theory of bipolar disorder, renewing interest in this field of research. PMID:25107282

  16. DeepBipolar: Identifying genomic mutations for bipolar disorder via deep learning.

    Science.gov (United States)

    Laksshman, Sundaram; Bhat, Rajendra Rana; Viswanath, Vivek; Li, Xiaolin

    2017-09-01

    Bipolar disorder, also known as manic depression, is a brain disorder that affects the brain structure of a patient. It results in extreme mood swings, severe states of depression, and overexcitement simultaneously. It is estimated that roughly 3% of the population of the United States (about 5.3 million adults) suffers from bipolar disorder. Recent research efforts like the Twin studies have demonstrated a high heritability factor for the disorder, making genomics a viable alternative for detecting and treating bipolar disorder, in addition to the conventional lengthy and costly postsymptom clinical diagnosis. Motivated by this study, leveraging several emerging deep learning algorithms, we design an end-to-end deep learning architecture (called DeepBipolar) to predict bipolar disorder based on limited genomic data. DeepBipolar adopts the Deep Convolutional Neural Network (DCNN) architecture that automatically extracts features from genotype information to predict the bipolar phenotype. We participated in the Critical Assessment of Genome Interpretation (CAGI) bipolar disorder challenge and DeepBipolar was considered the most successful by the independent assessor. In this work, we thoroughly evaluate the performance of DeepBipolar and analyze the type of signals we believe could have affected the classifier in distinguishing the case samples from the control set. © 2017 Wiley Periodicals, Inc.

  17. Comparison of depressive episodes in bipolar disorder and in major depressive disorder within bipolar disorder pedigrees.

    Science.gov (United States)

    Mitchell, Philip B; Frankland, Andrew; Hadzi-Pavlovic, Dusan; Roberts, Gloria; Corry, Justine; Wright, Adam; Loo, Colleen K; Breakspear, Michael

    2011-10-01

    Although genetic epidemiological studies have confirmed increased rates of major depressive disorder among the relatives of people with bipolar affective disorder, no report has compared the clinical characteristics of depression between these two groups. To compare clinical features of depressive episodes across participants with major depressive disorder and bipolar disorder from within bipolar disorder pedigrees, and assess the utility of a recently proposed probabilistic approach to distinguishing bipolar from unipolar depression. A secondary aim was to identify subgroups within the relatives with major depression potentially indicative of 'genetic' and 'sporadic' subgroups. Patients with bipolar disorder types 1 and 2 (n = 246) and patients with major depressive disorder from bipolar pedigrees (n = 120) were assessed using the Diagnostic Interview for Genetic Studies. Logistic regression was used to identify distinguishing clinical features and assess the utility of the probabilistic approach. Hierarchical cluster analysis was used to identify subgroups within the major depressive disorder sample. Bipolar depression was characterised by significantly higher rates of psychomotor retardation, difficulty thinking, early morning awakening, morning worsening and psychotic features. Depending on the threshold employed, the probabilistic approach yielded a positive predictive value ranging from 74% to 82%. Two clusters within the major depressive disorder sample were found, one of which demonstrated features characteristic of bipolar depression, suggesting a possible 'genetic' subgroup. A number of previously identified clinical differences between unipolar and bipolar depression were confirmed among participants from within bipolar disorder pedigrees. Preliminary validation of the probabilistic approach in differentiating between unipolar and bipolar depression is consistent with dimensional distinctions between the two disorders and offers clinical utility in

  18. Practical guidance for prescribing ziprasidone in acute manic or mixed episodes of bipolar I disorder.

    Science.gov (United States)

    Cañas, Fernando; Correll, Christoph U; Fagiolini, Andrea; Larmo, Ilkka; Levy, Pedro; Papageorgiou, Georgios; Rossi, Alessandro; Zink, Marhias; Montes, José Manuel

    2011-10-01

    Limited information is available on the clinical issues and strategies for optimal clinical usage of ziprasidone in the treatment of adult patients with acute manic or mixed episodes of bipolar disorder. To address those issues, information from clinical trials addressing the efficacy and tolerability of ziprasidone in acute bipolar mania was reviewed and supplemented with the input from an expert faculty of European psychiatrists with extensive experience in treating patients with bipolar mania, both in clinical trials and in everyday clinical practice. Effective use of oral ziprasidone in the treatment of acute bipolar mania requires rapid titration to doses in the range 120 - 160 mg/day and administration with meals of ≥ 500 kcal. As in the clinical trials, temporary short-term use of benzodiazepines (in particular lorazepam for agitation or temazepam for insomnia) could be advisable. Available evidence from randomized clinical trials in combination with clinical experience supports the use of ziprasidone as one of the first-line effective and safe treatments for acute manic or mixed episodes associated with bipolar I disorder.

  19. Inequality, Bi-Polarization and Mobility of Urban Infrastructure Investment in China’s Urban System

    Directory of Open Access Journals (Sweden)

    Lie Ma

    2017-09-01

    Full Text Available In periods of rapid urbanization, investment in urban infrastructure should not only meet the increasing demands of all urban people, but also be equally allocated between cities to achieve social equity and sustainable development. This paper aimed to conduct quantitative research on the unbalance of urban infrastructure investment between cities in China. The measurement models for inequality, bi-polarization and the mobility of urban infrastructure investment were constructed by means of the Gini coefficient, bi-polarization index and mobility function from the urban system, and an empirical study was conducted based on panel data from 2006 to 2014. The results show that: (1 The overall inequality of urban infrastructure investment in China’s urban system was relatively prominent and showed a “U-shaped” change generally. (2 The inequality between different administrative levels or regional cities only partially accounted for the overall inequality of China’s urban system. (3 Inequality and bi-polarization showed inconsistent performance. (4 Mobility played a positive role in reducing the inequality and bi-polarization. Based on the empirical findings and the reality of China’s urban infrastructure investment and financing, targeted policy suggestions were proposed in terms of adjusting inequality and bi-polarization, innovating investment and financing mechanisms, and optimizing urban infrastructure investment strategies.

  20. Trait impulsivity and increased pre-attentional sensitivity to intense stimuli in bipolar disorder and controls.

    Science.gov (United States)

    Lijffijt, Marijn; Lane, Scott D; Moeller, F Gerard; Steinberg, Joel L; Swann, Alan C

    2015-01-01

    Impulsivity and sensation seeking are stimulus-oriented traits. Because they differ in degree of intention and planning, they may have distinct neurophysiological mechanisms. Impulsivity is prominent in bipolar disorder, and may be related to pre-attentional information filtering and stimulus-orientation. We investigated specificity of relationships between impulsivity and sensitivity to stimulus intensity in bipolar disorder and controls, using intensity-sensitivity of auditory evoked potentials. Seventy-six subjects (37 healthy controls, 39 with bipolar disorder) were administered an intensity-sensitivity paradigm. Additional measures included Barratt Impulsiveness Scale (BIS-11) and Eysenck Impulsivity and Venturesomeness scores. State-dependent rapid-response impulsivity was measured using the Immediate Memory Task. Intensity-sensitivities of the auditory evoked P1N1, N1P2, P1, N1, and P2 potentials were assessed as the slope of amplitude relative to loudness. Analyses used general linear models (GLM) with impulsivity-related measures as dependent variables and age, gender, education, and diagnosis as dependent variables. BIS-11 total, motor, and attentional impulsivity scores correlated positively with pre-attentional N1 and P1N1 intensity-sensitivity slopes in bipolar disorder, but not in controls. BIS-11 nonplanning and Eysenck Venturesomeness scores did not correlate with intensity-sensitivity. Intensity-sensitivity slopes did not correlate with rapid-response impulsivity. Correlations between N1 or P1N1 slopes and BIS-11 scores in bipolar disorder were not affected by age, education, WAIS, treatment, symptoms, or gender. Trait impulsivity in bipolar disorder may be related to poorly modulated stimulus-driven late pre-attentional responses to stimuli, potentially resulting in exaggerated responses to intense stimuli even before conscious awareness. Components of trait impulsivity are physiologically heterogenous relative to intensity-sensitivity. Copyright

  1. Next Generation Bipolar Plates for Automotive PEM Fuel Cells

    Energy Technology Data Exchange (ETDEWEB)

    Adrianowycz, Orest; Norley, Julian; Stuart, David J; Flaherty, David; Wayne, Ryan; ; Williams, Warren; Tietze, Roger; Nguyen, Yen-Loan H; Zawodzinski, Tom; Pietrasz, Patrick

    2010-04-15

    The results of a successful U.S. Department of Energy (DoE) funded two-year $2.9 MM program lead by GrafTech International Inc. (GrafTech) are reported and summarized. The program goal was to develop the next generation of high temperature proton exchange membrane (PEM) fuel cell bipolar plates for use in transportation fuel cell applications operating at temperatures up to 120 °C. The bipolar plate composite developed during the program is based on GrafTech’s GRAFCELL resin impregnated flexible graphite technology and makes use of a high temperature Huntsman Advanced Materials resin system which extends the upper use temperature of the composite to the DoE target. High temperature performance of the new composite is achieved with the added benefit of improvements in strength, modulus, and dimensional stability over the incumbent resin systems. Other physical properties, including thermal and electrical conductivity of the new composite are identical to or not adversely affected by the new resin system. Using the new bipolar plate composite system, machined plates were fabricated and tested in high temperature single-cell fuel cells operating at 120 °C for over 1100 hours by Case Western Reserve University. Final verification of performance was done on embossed full-size plates which were fabricated and glued into bipolar plates by GrafTech. Stack testing was done on a 10-cell full-sized stack under a simulated drive cycle protocol by Ballard Power Systems. Freeze-thaw performance was conducted by Ballard on a separate 5-cell stack and shown to be within specification. A third stack was assembled and shipped to Argonne National Laboratory for independent performance verification. Manufacturing cost estimate for the production of the new bipolar plate composite at current and high volume production scenarios was performed by Directed Technologies Inc. (DTI). The production cost estimates were consistent with previous DoE cost estimates performed by DTI for the

  2. The bipolar ejection in MWC560

    Science.gov (United States)

    Ferrer, O. E.; Tomov, T.; Munari, U.; Brandi, E.; Garcia, L.; Georgiev, L.; Barba, R.

    1998-11-01

    The symbiotic binary MWC560 is a very peculiar system. Consisting of a M giant and a magnetic white dwarf companion, its behaviour resembles only that of CH Cyg. The massive and fast outflows and jets, the rapid variations in brightness with a time scale of the order of twenty minutes, and the alternance between low and high activity phases, are phenomena which only could be caused by the presence of the magnetic white dwarf secondary (Mikolajewski et al. 1997). The spectrum is clearly dominated by narrow emission lines of singly ionized metals and by the Balmer lines, which show variable profiles, consisting of a strong emission component and complex absorption profiles displaying two kinds of components: a broad component with velocities of the order of -300 Km/s, always present, and violet shifted components, with velocities between -300 Km/s and -7000 Km/s, produced by the discrete ejection of material along the line of sight (Tomov et al. 1990, 1992). The radial velocities of the narrow emission lines do not show any change, and so do the velocities of the absorption lines of the M giant, supporting then the idea of face-on location for the orbital plane of the system (Tomov & Kolev 1997). The emission of the Balmer lines could be formed in an accretion disk and/or envelope around the hot companion, and the violet-shifted absorption components would be caused by the bipolar ejection of highly collimated jets by the magnetized white dwarf (Tomov & Kolev 1997). Probable spectral signatures of this bipolar ejection were previously presented (Tomov et al 1997). We are presenting here a clear evidence of the presence of the corresponding red-shifted jets, signatures of which are seen in the behaviour of the red wing of the H alpha emission profiles, mirroring the strongly violet-shifted absorption components when present. We show high resolution H alpha profiles secured between 1993 and 1998 with the Rozhen (Bulgaria) 2-m, the Asiago (Italy) 1.82-m, the San Pedro

  3. Mood dynamics in bipolar disorder.

    Science.gov (United States)

    Moore, Paul J; Little, Max A; McSharry, Patrick E; Goodwin, Guy M; Geddes, John R

    2014-12-01

    The nature of mood variation in bipolar disorder has been the subject of relatively little research because detailed time series data has been difficult to obtain until recently. However some papers have addressed the subject and claimed the presence of deterministic chaos and of stochastic nonlinear dynamics. This study uses mood data collected from eight outpatients using a telemonitoring system. The nature of mood dynamics in bipolar disorder is investigated using surrogate data techniques and nonlinear forecasting. For the surrogate data analysis, forecast error and time reversal asymmetry statistics are used. The original time series cannot be distinguished from their linear surrogates when using nonlinear test statistics, nor is there an improvement in forecast error for nonlinear over linear forecasting methods. Nonlinear sample forecasting methods have no advantage over linear methods in out-of-sample forecasting for time series sampled on a weekly basis. These results can mean that either the original series have linear dynamics, the test statistics for distinguishing linear from nonlinear behaviour do not have the power to detect the kind of nonlinearity present, or the process is nonlinear but the sampling is inadequate to represent the dynamics. We suggest that further studies should apply similar techniques to more frequently sampled data.

  4. The Maudsley Bipolar Disorder Project.

    Science.gov (United States)

    Frangou, Sophia

    2005-01-01

    The Maudsley Bipolar Disorder Project set out to investigate the cognitive and brain structural and functional characteristics of Bipolar Disorder I (BDI). Participating patients were recruited while in remission from a secondary care setting and were matched to healthy volunteers in terms of age, gender, race, and years of education. All participants underwent extensive clinical and cognitive assessment. Brain structural and functional data also were obtained by using magnetic resonance imaging (MRI). Compared with controls, patients showed subtle widespread decrements, with executive function being more markedly impaired. Patients also showed volume decrements in the ventral prefrontal cortex (VPFC) bilaterally and the dorsal PFC (DPFC) on the left, whereas the volume of the amygdala was bilaterally enlarged. Patients showed subtle abnormalities in functional MRI in their DPFC, with marked decrements in activity in both the DPFC and VPFC in tasks that rely on the functional interaction of these brain regions. Our results suggest that BDI is associated with trait deficits in executive function and in the structure and function of the PFC.

  5. Lower switch rate in depressed patients with bipolar II than bipolar I disorder treated adjunctively with second-generation antidepressants

    NARCIS (Netherlands)

    Altshuler, LL; Suppes, T; Nolen, WA; Leverich, G; Keck, PE; Frye, MA; Kupka, R; McElroy, SL; Grunze, H; Kitchen, CMR; Post, R; Black, D.O.

    Objectives: The authors compared the switch rate into hypomania/mania in depressed patients treated with second-generation antidepressants who had either bipolar I or bipolar II disorder. Method: In a 10-week trial, 184 outpatients with bipolar depression (134 with bipolar I disorder, 48 with

  6. Brief Report: A Family Risk Study Exploring Bipolar Spectrum Problems and Cognitive Biases in Adolescent Children of Bipolar Parents

    Science.gov (United States)

    Espie, Jonathan; Jones, Steven H.; Vance, Yvonne H.; Tai, Sara J.

    2012-01-01

    Children of parents with bipolar disorder are at increased risk of bipolar spectrum diagnoses. This cross-sectional study explores cognitive factors in the prediction of vulnerability to bipolar disorder. Adolescents at high-risk (with a parent with bipolar disorder; n = 23) and age and gender matched adolescents (n = 24) were recruited. Parent…

  7. The bipolar spectrum: conceptions and misconceptions.

    Science.gov (United States)

    Ghaemi, S Nassir; Dalley, Shannon

    2014-04-01

    This review aims to address concerns about the potential overinclusiveness and vagueness of bipolar spectrum concepts, and also, concerns about the overlap between bipolar illness and borderline personality. Narrative review based on historical and empirical studies. Bipolar disorder (BD) and major depressive disorder (MDD) came to be separate entities with the Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM III), in contrast to the Kraepelinian manic-depressive insanity (MDI) concept, which included both. The bipolar spectrum concept is a return to this earlier Kraepelinian perspective. Further, very different features differentiate the disease of bipolar illness (family history of bipolar illness, severe recurrent mood episodes with psychomotor activation) from the clinical picture of borderline personality (dissociative symptoms, sexual trauma, parasuicidal self-harm). The term 'disorder' obfuscates an ontological difference between diseases, such as manic-depressive illness, and clinical pictures, such as hysteria/post-traumatic stress disorder/dissociation/borderline personality. Bipolar spectrum concepts are historically rooted in Kraepelin's manic-depressive illness concept, are scientifically testable, and can be clearly formulated. Further, they differ in kind from traumatic/dissociative conditions in ways that can be both historically and scientifically established.

  8. Impulsivity across the course of bipolar disorder

    Science.gov (United States)

    Strakowski, Stephen M.; Fleck, David E.; DelBello, Melissa P.; Adler, Caleb M.; Shear, Paula K.; Kotwal, Renu; Arndt, Stephan

    2010-01-01

    Objective To determine whether abnormalities of impulse control persist across the course of bipolar disorder, thereby representing potential state markers and endophenotypes. Methods Impulse control of 108 bipolar I manic or mixed patients was measured on three tasks designed to study response inhibition, ability to delay gratification, and attention; namely a stop signal task, a delayed reward task, and a continuous performance task, respectively. Barrett Impulsivity Scale (BIS-11) scores were also obtained. Patients were then followed for up to one year and re-assessed with the same measures if they developed depression or euthymia. Healthy comparison subjects were also assessed with the same instruments on two occasions to assess measurement stability. Results At baseline, bipolar subjects demonstrated significant deficits on all three tasks as compared to healthy subjects, consistent with more impulsive responding in the bipolar manic/mixed group. In general, performance on the three behavioral tasks normalized upon switching to depression or developing euthymia. In contrast, BIS-11 scores were elevated during mania and remained elevated as bipolar subjects developed depression or achieved euthymia. Conclusions Bipolar I disorder patients demonstrate deficits on laboratory tests of various aspects of impulsivity when manic, as compared to healthy subjects, that largely normalize with recovery and switching into depression. However, elevated BIS scores persist across phases of illness. These findings suggest that impulsivity has both affective-state dependent and trait components in bipolar disorder. PMID:20565435

  9. Violence in schizophrenia and bipolar disorder.

    Science.gov (United States)

    Volavka, Jan

    2013-03-01

    Although most psychiatric patients are not violent, serious mental illness is associated with increased risk of violent behavior. Most of the evidence available pertains to schizophrenia and bipolar disorder. MEDLINE data base was searched for articles published between 1966 and November 2012 using the combination of key words 'schizophrenia' or 'bipolar disorder' with 'aggression' or 'violence'. For the treatment searches, generic names were used in combination with key words 'schizophrenia' or 'bipolar disorder' and 'aggression' No language constraint was applied. Only articles dealing with adults were included. The lists of references were searched manually to find additional articles. There were statistically significant increases of risk of violence in schizophrenia and in bipolar disorder in comparison with general population. The evidence suggests that the risk of violence is greater in bipolar disorder than in schizophrenia. Most of the violence in bipolar disorder occurs during the manic phase. The risk of violence in schizophrenia and bipolar disorder is increased by comorbid substance use disorder. Violence among adults with schizophrenia may follow at least two distinct pathways-one associated with antisocial conduct, and another associated with the acute psychopathology of schizophrenia. Clozapine is the most effective treatment of aggressive behavior in schizophrenia. Emerging evidence suggests that olanzapine may be the second line of treatment. Treatment adherence is of key importance. Non-pharmacological methods of treatment of aggression in schizophrenia and bipolar disorder are increasingly important. Cognitive behavioral approaches appear to be effective in cases where pharmacotherapy alone does not suffice. Violent behavior of patients with schizophrenia and bipolar disorder is a public health problem. Pharmacological and non-pharmacological approaches should be used to treat not only violent behavior, but also contributing comorbidities such

  10. Sexuality and Sexual Dysfunctions in Bipolar Disorder

    Directory of Open Access Journals (Sweden)

    Zeynep Namli

    2016-12-01

    Full Text Available In the clinical course of bipolar disorder, there is a reduction in sexual will during depressive episodes and inappopriate sexual experiences and hypersexuality occurs during manic episodes. Up to now, studies focused on sexual side effects of drugs. Sexual violence, sexually transmitted diseases, contraception methods, unplanned pregnancies need to be assessed carefully in bipolar disorder patients. This review focused on sexuality and sexual dysfunctions in the course of bipolar disorder. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2016; 8(4.000: 309-320

  11. Paired structures and bipolar knowledge representation

    DEFF Research Database (Denmark)

    Montero, Javier; Bustince, Humberto; Franco, Camilo

    In this strictly positional paper we propose a general approach to bipolar knowledge representation, where the meaning of concepts can be modelled by examining their decomposition into opposite and neutral categories. In particular, it is the semantic relationship between the opposite categories...... and at the same time the type of neutrality rising in between opposites. Based on this first level of bipolar knowledge representation, paired structures in fact offer the means to characterize a specific bipolar valuation scale depending on the meaning of the concept that has to be verified. In this sense...

  12. Bipolar Disorder and Early Affective Trauma.

    Science.gov (United States)

    de Codt, Aloise; Monhonval, Pauline; Bongaerts, Xavier; Belkacemi, Ikram; Tecco, Juan Martin

    2016-09-01

    Bipolar disorder is a chronic psychiatric disease with a high prevalence and is a major psychosocial and medical burden. The exact etiological pathways of bipolar disorder are not fully understood. Genetic factors are known to play an important role in the etiology of bipolar disorder. However, high rates of discordance among identical twins and a growing body of evidence that environmental factors such as early stress can influence the onset and course of psychiatric diseases underline the importance of additional etiological mechanisms of bipolar disorders. There has been little investigation about early trauma in bipolar disorder. The aim of this study was to review the literature on the association between early traumatic interactions like child neglect, mistreatment, abuse or early parental separation and the occurrence of bipolar disorder in adulthood or impact on the course of the disease. Studies investigating associations between child neglect, mistreatment, abuse or early parental separation and occurrence of bipolar disorder in adulthood or impact on the course of the disease were searched in the Pubmed database. More than 700 articles were sorted independently by two of the authors using predefined criteria. Only research articles, reviews and meta-analyses were selected for this review. 53 articles met the inclusion criteria. To date, four systematic reviews partially addressed our research question. Early trauma is more frequently found in the past of bipolar patients than in the general population. Studies support a harmful effect of childhood trauma on the course of bipolar disease, with more anxious, depressive or psychotic symptoms, an early age of onset and a worse prognosis. Early trauma is more often found in the past of bipolar adult patients than the general population and studies support a harmful effect of childhood trauma on the course of bipolar disease, with more anxious, depressive or psychotic symptoms, an early age of onset and a

  13. Progression along the Bipolar Spectrum: A Longitudinal Study of Predictors of Conversion from Bipolar Spectrum Conditions to Bipolar I and II Disorders

    Science.gov (United States)

    Alloy, Lauren B.; Urošević, Snežana; Abramson, Lyn Y.; Jager-Hyman, Shari; Nusslock, Robin; Whitehouse, Wayne G.; Hogan, Michael

    2011-01-01

    Little longitudinal research has examined progression to more severe bipolar disorders in individuals with “soft” bipolar spectrum conditions. We examine rates and predictors of progression to bipolar I and II diagnoses in a non-patient sample of college-age participants (n = 201) with high General Behavior Inventory scores and childhood or adolescent onset of “soft” bipolar spectrum disorders followed longitudinally for 4.5 years from the Longitudinal Investigation of Bipolar Spectrum (LIBS) project. Of 57 individuals with initial cyclothymia or bipolar disorder not otherwise specified (BiNOS) diagnoses, 42.1% progressed to a bipolar II diagnosis and 10.5% progressed to a bipolar I diagnosis. Of 144 individuals with initial bipolar II diagnoses, 17.4% progressed to a bipolar I diagnosis. Consistent with hypotheses derived from the clinical literature and the Behavioral Approach System (BAS) model of bipolar disorder, and controlling for relevant variables (length of follow-up, initial depressive and hypomanic symptoms, treatment-seeking, and family history), high BAS sensitivity (especially BAS Fun Seeking) predicted a greater likelihood of progression to bipolar II disorder, whereas early age of onset and high impulsivity predicted a greater likelihood of progression to bipolar I (high BAS sensitivity and Fun-Seeking also predicted progression to bipolar I when family history was not controlled). The interaction of high BAS and high Behavioral Inhibition System (BIS) sensitivities also predicted greater likelihood of progression to bipolar I. We discuss implications of the findings for the bipolar spectrum concept, the BAS model of bipolar disorder, and early intervention efforts. PMID:21668080

  14. Treatment adherence in bipolar I and schizoaffective disorder, bipolar type.

    Science.gov (United States)

    Murru, A; Pacchiarotti, I; Amann, B L; Nivoli, A M A; Vieta, E; Colom, F

    2013-12-01

    Poor adherence rates in Bipolar Disorder type I (BDI) and Schizoaffective Disorder, bipolar type (SAD) may be high This study was aimed at comparing the clinical correlates of adherence to treatment and the course of illness in BDI and SAD patients. 75 SAD and 150 BDI DSM-IV outpatients were included. Adherence was assessed on the basis of patients' and care-givers' reports and serum levels, when available. Socio-demographic, clinical and treatment variables were collected and compared between diagnostic subsamples and then between goodly and poorly adherent patients. Multiple logistic regressions were performed, controlling for diagnostic subsample differences, to identify correlates of adherence in BDI and SAD groups. Poor adherence was highly prevalent both in BDI (32%) and in SAD patients (44%), with no significant differences between diagnostic categories. Presence of psychotic symptoms (p=0.029), higher number of manic relapses (pdisorders (p=0.002), and lithium therapy (p=0.003) were associated with poor adherence to treatment. Diagnostic subgroup analyses showed different predictive models, with the BDI poorly adherent subsample being more likely to include comorbid personality and manic recurrences and the SAD poorly adherent subsample being less clinically predictable. The cross-sectional nature of the study limits de capacity to ascertain the direction of the relationship between certain variables. Rates of poor adherence to oral treatments are similar in SAD and BDI. BDI patients with comorbid personality and substance use disorders are likely to be poorly adherent. Treatment adherence may be more difficult to predict in SAD patients. © 2013 Elsevier B.V. All rights reserved.

  15. Tratamento do transtorno bipolar: eutimia Bipolar disorder treatment: euthymia

    Directory of Open Access Journals (Sweden)

    Fábio Gomes de Matos e Souza

    2005-01-01

    Full Text Available O transtorno bipolar é um quadro complexo caracterizado por episódios de depressão, mania ou hipomania e fases assintomáticas. O tratamento visa ao controle de episódios agudos e prevenção de novos episódios. O tratamento farmacológico iniciou-se com o lítio. Até o momento, o lítio permanece como o tratamento com mais evidências favoráveis na fase de manutenção. Outros tratamentos demonstram eficácia nessa fase, como o valproato, a carbamazepina e os antipsicóticos atípicos. Dos antipsicóticos atípicos o mais estudado nesta fase do tratamento é a olanzapina. Mais estudos prospectivos são necessários para confirmar a ação profilática de novos agentes.Bipolar disorder is a complex disorder characterized by depression episodes, mania or hypomania and asymptomatic phases. The treatment aims at the control of acute episodes and prevention of new episodes. The pharmacological treatment was inaugurated with lithium. Until the moment, lithium remains as the treatment with more favorable evidences in the maintenance phase. Other treatments demonstrate efficacy in this phase, as valproate, carbamazepine and atypical antipsychotics. Of the atypical antipsychotics, the most studied in this phase of treatment is olanzapine. More prospective studies are necessary to confirm prophylactic action of new agents.

  16. Behavioral reversal of lithium effects by four inositol isomers correlates perfectly with biochemical effects on the PI cycle: depletion by chronic lithium of brain inositol is specific to hypothalamus, and inositol levels may be abnormal in postmortem brain from bipolar patients.

    Science.gov (United States)

    Belmaker, R H; Agam, G; van Calker, D; Richards, M H; Kofman, O

    1998-09-01

    The inositol depletion hypothesis of lithium (Li) action has been criticized, because depletion of inositol after chronic Li treatment has not been reproducible, effects of inositol to reverse Li-induced behaviors occurred also with epi-inositol, a unnatural isomer, and because inositol is ubiquitous in brain and hard to relate to the pathogenesis of affective disorder. Therefore, we review our studies showing that lithium depletion of brain inositol occurs chronically in the hypothalamus, a region not previously examined; that behavioral effects of four different inositol isomers including epi-inositol correlate perfectly with their biochemical effects; and that inositol in postmortem human brain is reduced by 25% in frontal cortex of bipolars and suicides as compared with controls. Because inositol in postmortem brain is reduced and not increased in bipolar patients, the relationship between inositol, lithium, and affective disorder is complex.

  17. Bipolar Electrode Sample Preparation Devices

    Science.gov (United States)

    Wang, Yi (Inventor); Song, Hongjun (Inventor); Pant, Kapil (Inventor)

    2017-01-01

    An analyte selection device can include: a body defining a fluid channel having a channel inlet and channel outlet; a bipolar electrode (BPE) between the inlet and outlet; one of an anode or cathode electrically coupled with the BPE on a channel inlet side of the BPE and the other of the anode or cathode electrically coupled with the BPE on a channel outlet side of the BPE; and an electronic system operably coupled with the anode and cathode so as to polarize the BPE. The fluid channel can have any shape or dimension. The channel inlet and channel outlet can be longitudinal or lateral with respect to the longitudinal axis of the channel. The BPE can be any metallic member, such as a flat plate on a wall or mesh as a barrier BPE. The anode and cathode can be located at a position that polarizes the BPE.

  18. Mortality gap for people with bipolar disorder and schizophrenia: UK-based cohort study 2000-2014.

    Science.gov (United States)

    Hayes, Joseph F; Marston, Louise; Walters, Kate; King, Michael B; Osborn, David P J

    2017-09-01

    BackgroundBipolar disorder and schizophrenia are associated with increased mortality relative to the general population. There is an international emphasis on decreasing this excess mortality.AimsTo determine whether the mortality gap between individuals with bipolar disorder and schizophrenia and the general population has decreased.MethodA nationally representative cohort study using primary care electronic health records from 2000 to 2014, comparing all patients diagnosed with bipolar disorder or schizophrenia and the general population. The primary outcome was all-cause mortality.ResultsIndividuals with bipolar disorder and schizophrenia had elevated mortality (adjusted hazard ratio (HR) = 1.79, 95% CI 1.67-1.88 and 2.08, 95% CI 1.98-2.19 respectively). Adjusted HRs for bipolar disorder increased by 0.14/year (95% CI 0.10-0.19) from 2006 to 2014. The adjusted HRs for schizophrenia increased gradually from 2004 to 2010 (0.11/year, 95% CI 0.04-0.17) and rapidly after 2010 (0.34/year, 95% CI 0.18-0.49).ConclusionsThe mortality gap between individuals with bipolar disorder and schizophrenia, and the general population is widening. © The Royal College of Psychiatrists 2017.

  19. Climatic factors and bipolar affective disorder

    DEFF Research Database (Denmark)

    Christensen, Ellen Margrethe; Larsen, Jens Knud; Gjerris, Annette

    2008-01-01

    In bipolar disorder, the factors provoking a new episode are unknown. As a seasonal variation has been noticed, it has been suggested that weather conditions may play a role. The aim of the study was to elucidate whether meteorological parameters influence the development of new bipolar phases....... A group of patients with at least three previous hospitalizations for bipolar disorder was examined every 3 months for up to 3 years. At each examination an evaluation of the affective phase was made according to the Hamilton Depression Scale (HAM-D(17)), and the Bech-Rafaelsen Mania Rating Scale (MAS......). In the same period, daily recordings from the Danish Meteorological Institute were received. We found no correlations between onset of bipolar episodes [defined as MAS score of 11 or more (mania) and as HAM-D(17) score of 12 or more (depression)] and any meteorological parameters. We found a statistical...

  20. Bipolar separator plate for electrochemical cells

    Energy Technology Data Exchange (ETDEWEB)

    Balko, E. N.; Moulthrop, L. W.

    1985-08-06

    Shunt currents which flow between the electrodes of adjacent cells through the moving conductive fluid and the fluid pool in the manifold of a bipolar cell assembly are minimized by introducing the conductive fluid at the top of an elongated outlet manifold. This results in cascaded flow which interrupts the current path. Shunt currents between the fluid manifold walls of the conductive bipolar elements in the series connected electrochemical cell assemblies are minimized by insulating the manifold walls with insulating, elastomeric sealing grommets. This prevents current flow between the manifold walls through the electrically conductive fluid in the manifold and provides an edgeseal between bipolar plates. The instant invention relates to a process and apparatus for electrochemical cell assemblies and more particularly, for reducing shunt current in series connected bipolar assemblies.

  1. Bipolar or unipolar? : A brain teasing question

    NARCIS (Netherlands)

    Rive, M.M.

    2017-01-01

    During the depressed or remitted states, major depressive disorder (MDD) and bipolar disorder (BD) are difficult to distinguish clinically. Treatments for both disorders differ, and inadequate treatment may lead to chronicity, poor psychosocial functioning, or even suicide. Although early

  2. Are rates of pediatric bipolar disorder increasing?

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel; Vradi, Eleni; Andersen, Per Kragh

    2014-01-01

    for pediatric mania/bipolar disorder changed during the calendar period (1995 to 2003 versus 2004 to 2012), and (3) whether the diagnosis is more often made at first psychiatric contact in recent time compared to earlier according to gender. Totally, 346 patients got a main diagnosis of a manic episode (F30......Studies from the USA suggest that rates of pediatric bipolar disorder have increased since the mid-90s, but no study outside the USA has been published on the rates of pediatric bipolar disorder. Further, it is unclear whether an increase in rates reflects a true increase in the illness or more...... diagnostic attention. Using nationwide registers of all inpatients and outpatients contacts to all psychiatric hospitals in Denmark, we investigated (1) gender-specific rates of incident pediatric mania/bipolar disorder during a period from 1995 to 2012, (2) whether age and other characteristics...

  3. Bipolar disorder and neurophysiologic mechanisms

    Directory of Open Access Journals (Sweden)

    Simon M McCrea

    2008-11-01

    Full Text Available Simon M McCreaDepartments of Neurology and Neuroophthalmology, University of British Columbia, 2550 Willow Street, Vancouver, British Columbia, Canada V5Z 3N9Abstract: Recent studies have suggested that some variants of bipolar disorder (BD may be due to hyperconnectivity between orbitofrontal (OFC and temporal pole (TP structures in the dominant hemisphere. Some initial MRI studies noticed that there were corpus callosum abnormalities within specific regional areas and it was hypothesized that developmentally this could result in functional or effective connectivity changes within the orbitofrontal-basal ganglia-thalamocortical circuits. Recent diffusion tensor imaging (DTI white matter fiber tractography studies may well be superior to region of interest (ROI DTI in understanding BD. A “ventral semantic stream” has been discovered connecting the TP and OFC through the uncinate and inferior longitudinal fasciculi and the elusive TP is known to be involved in theory of mind and complex narrative understanding tasks. The OFC is involved in abstract valuation in goal and sub-goal structures and the TP may be critical in binding semantic memory with person–emotion linkages associated with narrative. BD patients have relative attenuation of performance on visuoconstructional praxis consistent with an atypical localization of cognitive functions. Multiple lines of evidence suggest that some BD alleles are being selected for which could explain the enhanced creativity in higher-ability probands. Associations between ROI’s that are not normally connected could explain the higher incidence of artistic aptitude, writing ability, and scientific achievements among some mood disorder subjects.Keywords: bipolar disorder, diffusion tensor imaging, white matter tractography, inferior longitudinal fasciculus, inferior fronto-occipital fasciculus, uncinate fasciculus, mood dysphoria, creativity, ventral semantic stream, writing ability, artistic aptitude

  4. Miniature Bipolar Electrostatic Ion Thruster

    Science.gov (United States)

    Hartley, Frank T.

    2006-01-01

    The figure presents a concept of a bipolar miniature electrostatic ion thruster for maneuvering a small spacecraft. The ionization device in the proposed thruster would be a 0.1-micron-thick dielectric membrane with metal electrodes on both sides. Small conical holes would be micromachined through the membrane and electrodes. An electric potential of the order of a volt applied between the membrane electrodes would give rise to an electric field of the order of several mega-volts per meter in the submicron gap between the electrodes. An electric field of this magnitude would be sufficient to ionize all the molecules that enter the holes. In a thruster-based on this concept, one or more propellant gases would be introduced into such a membrane ionizer. Unlike in larger prior ion thrusters, all of the propellant molecules would be ionized. This thruster would be capable of bipolar operation. There would be two accelerator grids - one located forward and one located aft of the membrane ionizer. In one mode of operation, which one could denote the forward mode, positive ions leaving the ionizer on the backside would be accelerated to high momentum by an electric field between the ionizer and an accelerator grid. Electrons leaving the ionizer on the front side would be ejected into free space by a smaller accelerating field. The equality of the ion and electron currents would eliminate the need for an additional electron- or ion-emitting device to keep the spacecraft charge-neutral. In another mode of operation, which could denote the reverse mode, the polarities of the voltages applied to the accelerator grids and to the electrodes of the membrane ionizer would be the reverse of those of the forward mode. The reversal of electric fields would cause the ion and electrons to be ejected in the reverse of their forward mode directions, thereby giving rise to thrust in the direction opposite that of the forward mode.

  5. Safety of hormonal contraception and intrauterine devices among women with depressive and bipolar disorders: a systematic review.

    Science.gov (United States)

    Pagano, H Pamela; Zapata, Lauren B; Berry-Bibee, Erin N; Nanda, Kavita; Curtis, Kathryn M

    2016-12-01

    Women with depressive or bipolar disorders are at an increased risk for unintended pregnancy. To examine the safety of hormonal contraception among women with depressive and bipolar disorders. We searched for articles published through January 2016 on the safety of using any hormonal contraceptive method among women with depressive or bipolar disorders, including those who had been diagnosed clinically or scored above threshold levels on a validated screening instrument. Outcomes included changes in symptoms, hospitalization, suicide and modifications in medication regimens such as increase or decrease in dosage or changes in type of drug. Of 2376 articles, 6 met the inclusion criteria. Of three studies that examined women clinically diagnosed with depressive or bipolar disorder, one found that oral contraceptives (OCs) did not significantly change mood across the menstrual cycle among women with bipolar disorder, whereas mood did significantly change across the menstrual cycle among women not using OCs; one found no significant differences in the frequency of psychiatric hospitalizations among women with bipolar disorder who used depot medroxyprogesterone acetate (DMPA), intrauterine devices (IUDs) or sterilization; and one found no increase in depression scale scores among women with depression using and not using OCs, for both those treated with fluoxetine and those receiving placebo. Of three studies that examined women who met a threshold for depression on a screening instrument, one found that adolescent girls using combined OCs (COCs) had significantly improved depression scores after 3 months compared with placebo, one found that OC users had similar odds of no longer being depressed at follow-up compared with nonusers, and one found that COC users were less frequently classified as depressed over 11 months than IUD users. Limited evidence from six studies found that OC, levonorgestrel-releasing IUD and DMPA use among women with depressive or bipolar

  6. Mood and metabolic consequences of sleep deprivation as a potential endophenotype' in bipolar disorder.

    Science.gov (United States)

    Aydin, Adem; Selvi, Yavuz; Besiroglu, Lutfullah; Boysan, Murat; Atli, Abdullah; Ozdemir, Osman; Kilic, Sultan; Balaharoglu, Ragıp

    2013-09-05

    It has been commonly recognized that circadian rhythm and sleep/wake cycle are causally involved in bipolar disorder. There has been a paucity of systematic research considering the relations between sleep and mood states in bipolar disorder. The current study examines the possible influences of sleep deprivation on mood states and endocrine functions among first-degree relatives of patients with bipolar disorder and healthy controls. Blood samples were taken at two time points in the consecutive mornings at predeprivation and postdeprivation periods. Participants simultaneously completed the Profiles of Mood States at two time points after giving blood samples. Plasma T3 and TSH levels increased after total sleep deprivation in both groups. Sleep deprivation induced TSH levels were reversely associated with depression-dejection among healthy controls. A paradoxical effect was detected for only the first-degree relatives of the patients that changes in plasma cortisol levels negatively linked to depression-dejection and anger-hostility scores after total sleep deprivation. Plasma DHEA levels became correlated with vigor-activity scores after sleep deprivation among first-degree relatives of bipolar patients. On the contrary, significant associations of depression-dejection, anger-hostility, and confusion-bewilderment with the baseline plasma DHEA levels became statistically trivial in the postdeprivation period. Findings suggested that first-degree relatives of patients with bipolar disorder had completely distinct characteristics with respect to sleep deprivation induced responses in terms of associations between endocrine functions and mood states as compared to individuals whose relatives had no psychiatric problems. Considering the relationships between endocrine functions and mood states among relatives of the patients, it appears like sleep deprivation changes the receptor sensitivity which probably plays a pivotal role on mood outcomes among the first

  7. Bipolar transistor in VESTIC technology: prototype

    Science.gov (United States)

    Mierzwiński, Piotr; Kuźmicz, Wiesław; Domański, Krzysztof; Tomaszewski, Daniel; Głuszko, Grzegorz

    2016-12-01

    VESTIC technology is an alternative for traditional CMOS technology. This paper presents first measurement data of prototypes of VES-BJT: bipolar transistors in VESTIC technology. The VES-BJT is a bipolar transistor on the SOI substrate with symmetric lateral structure and both emitter and collector made of polysilicon. The results indicate that VES-BJT can be a device with useful characteristics. Therefore, VESTIC technology has the potential to become a new BiCMOS-type technology with some unique properties.

  8. Biological dysrhythm in remitted bipolar I disorder.

    Science.gov (United States)

    Iyer, Aishwarya; Palaniappan, Pradeep

    2017-05-17

    Recent treatment guidelines support treatment of biological rhythm abnormalities as a part of treatment of bipolar disorder, but still, literature examining various domains (Sleep, Activity, Social, and Eating) of biological rhythm and its clinical predictors are less. The main aim of our study is to compare various domains of biological rhythm among remitted bipolar I subjects and healthy controls. We also explored for any association between clinical variables and biological rhythm among bipolar subjects. 40 subjects with Bipolar I disorder and 40 healthy controls who met inclusion and exclusion criteria were recruited for the study. Diagnoses were ascertained by a qualified psychiatrist using MINI 5.0. Sociodemographic details, biological rhythm (BRIAN-Biological Rhythm Interview of assessment in Neuropsychiatry) and Sleep functioning (PSQI- Pittsburgh Sleep Quality Index) were assessed in all subjects. Mean age of the Bipolar subjects and controls were 41.25±11.84years and 38.25±11.25 years respectively. Bipolar subjects experienced more biological rhythm disturbance when compared to healthy controls (total BRIAN score being 34.25±9.36 vs 28.2±6.53) (p=0.002). Subsyndromal depressive symptoms (HDRS) had significant positive correlation with BRIAN global scores(r=0.368, p=0.02). Linear regression analysis showed that number of episodes which required hospitalization (β=0.601, t=3.106, P=0.004), PSQI (β=0.394, t=2.609, p=0.014), HDRS (β=0.376, t=2.34, t=0.036) explained 31% of variance in BRIAN scores in remitted bipolar subjects. Biological rhythm disturbances seem to persist even after clinical remission of bipolar illness. More studies to look into the impact of subsyndromal depressive symptoms on biological rhythm are needed. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Fibromyalgia and bipolar disorder: a potential problem?

    Science.gov (United States)

    Wilke, William S; Gota, Carmen E; Muzina, David J

    2010-08-01

    To screen patients with fibromyalgia for bipolar disorder and to determine if there were any clinical clues, other than the Mood Disorders Questionnaire (MDQ), which might suggest a diagnosis of comorbid bipolar disorder. A total of 128 consecutive new fibromyalgia patients referred to a tertiary care center rheumatology practice were enrolled and assessed using a standard clinical protocol that included the completion of four screening questionnaires: (i) MDQ for bipolar disorder, (ii) Beck Depression Inventory (BDI) for depression, (iii) Epworth Sleepiness Scale (ESS) for daytime sleepiness, and (iv) Fibromyalgia Impact Questionnaire Disability Index (FIQ-DI) to assess for functional capacity. A quarter of the fibromyalgia subjects, 25.19%, had a positive screen for bipolar disorder (MDQ >or= 7); 78.12% were clinically depressed (BDI >or= 10); and 52.13% reported daytime sleepiness (ESS >or= 10). Fibromyalgia subjects who screened positive for bipolar disorder had more severe depression than those with a negative screen [median BDI: 26.0 (19.0, 32.0) versus 15.0 (9.0, 24.0), p < 0.001]. We report a high prevalence of positive testing for bipolar disorder in this fibromyalgia cohort. Clinical data and questionnaire instruments other than nonspecific high depression severity failed to identify these patients. Since the norepinephrine serotonin reuptake inhibitors duloxetine and milnacipran have been recently approved by the U.S. Food and Drug Administration for the treatment of fibromyalgia, and because patients with bipolar disorder may experience destabilization of mood when treated with such agents, patients with fibromyalgia should be systematically screened for bipolar disorder prior to treatment. (c) 2010 John Wiley & Sons A/S.

  10. Face and predictive validity of the ClockΔ19 mouse as an animal model for bipolar disorder: a systematic review.

    Science.gov (United States)

    Kristensen, M; Nierenberg, A A; Østergaard, S D

    2018-01-01

    Mice carrying the circadian locomotor output cycles Kaput delta 19 N-ethyl-N-nitrosoure (ENU) mutation (ClockΔ19) are used as an animal model for bipolar disorder (BD). We aimed to systematically review the face validity (phenotypical and pathophysiological resemblance with BD) and predictive validity (responsiveness to treatments used in BD) of this model in adherence with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. We carried out a systematic search of the databases PubMed and Embase, combining search terms covering BD and ClockΔ19. The 22 studies included in the review (from a total of 1281 identified records) show that the behavioral phenotype of the ClockΔ19 mouse is characterized by hyperactivity, decreased anxiety-like behavior, decreased depression-like behavior and increased preference for rewarding stimuli. This is highly consistent with mania in humans. Moreover, the ClockΔ19 mouse exhibits rapid mood cycling (a manic-like phenotype during the day followed by euthymia at night), which is consistent with BD. Chronic administration of lithium, a drug with well established mood-stabilizing effect in humans with BD, reverses the majority of the bipolar-like traits and most of the neurobiological abnormalities observed in the ClockΔ19 mouse. In conclusion, the ClockΔ19 mouse has substantial face validity as an animal model for BD. The predictive validity of the ClockΔ19 mouse has primarily been investigated via studies using lithium challenge. Therefore, further studies are needed to determine how the ClockΔ19 mouse responds to other mood-stabilizing treatments of BD such as valproate, lamotrigine, carbamazepine, oxcarbazepine, antipsychotics, electroconvulsive therapy and various light interventions.

  11. Preparation of bipolar membranes by electrospinning

    Energy Technology Data Exchange (ETDEWEB)

    Pan, Jiefeng; Hou, Linxiao; Wang, Qiuyue; He, Yubin; Wu, Liang; Mondal, Abhishek N.; Xu, Tongwen, E-mail: twxu@ustc.edu.cn

    2017-01-15

    A new preparative pathway for the bipolar membranes was initiated via the electrospinning and hot-press process. The prepared bipolar membrane was consisting of sulfonated poly (phenylene oxide), polyethylene glycol, and quaternized poly (phenylene oxide). The above mentioned membrane was fabricated by the continuous electrospinning of the respective layer, followed by the solvent atmosphere treatment and hot-pressing, to obtain a transparent and dense structure. The thickness of each layer can be easily tuned by controlling the electrospinning parameters. The clear interfacial structure was observed and confirmed by the scanning electron microscope. The bipolar performance is evaluated by the current–voltage curves and production yield of acid and base. The final optimized bipolar membrane had similar yield of acid and base as the casting membrane. However, extremely lower potential drop value was observed when they are applied for the production of acid and base. The experimental results showed that, electrospinning is an effective and well controlled way to fabricate bipolar membranes, in which anion or cation exchange layer as well as interfacial layer can be easily changed or added as requested. - Highlights: • Bipolar membranes were prepared through electrospinning followed by post-treatment. • As-prepared membranes were successfully applied in electrodialysis for production of acid and base. • Electrospun membranes exhibit better performance than the casting ones.

  12. Early maladaptive schemas in bipolar disorder.

    Science.gov (United States)

    Ak, Mehmet; Lapsekili, Nergis; Haciomeroglu, Bikem; Sutcigil, Levent; Turkcapar, Hakan

    2012-09-01

    According to the cognitive model of depression, negative schemas, formed in early life, increase susceptibility to depression. The objective of this study was to investigate schemas that are proposed to increase susceptibility of depression in bipolar disorder patients who have had depressive episodes. Eighteen patients diagnosed with bipolar disorder according to DSM-IV and a healthy control group (N= 20) constituted the sample of the study. The Beck Depression Inventory, Young Mania Rating Scale, and Young Schema Scale were applied to patients in order to determine the level of symptoms and schemas. When the scores obtained from Young Schema Scale were compared between groups, significant differences were observed between bipolar patients and control group on all the schemas except abandonment, emotional deprivation, defectiveness, vulnerability to harm or illness, and approval seeking. The negative schema scores of bipolar patients were significantly higher than those of the control group. Of all schemas included in the Young Schema Scale, the scores of bipolar group were higher than the scores of the control group. These findings suggest that, in cognitive-based psychotherapeutic approaches for patients with bipolar disorder, it would be more effective to focus on schemas related to the perception and allowance of feelings at the proper time and the instability of self-perceptions. © 2011 The British Psychological Society.

  13. Classification of cognitive performance in bipolar disorder.

    Science.gov (United States)

    Sparding, Timea; Silander, Katja; Pålsson, Erik; Östlind, Josefin; Ekman, Carl Johan; Sellgren, Carl M; Joas, Erik; Hansen, Stefan; Landén, Mikael

    2017-09-01

    To understand the etiology of cognitive impairment associated with bipolar disorder, we need to clarify potential heterogeneity in cognitive functioning. To this end, we used multivariate techniques to study if the correlation structure of cognitive abilities differs between persons with bipolar disorder and controls. Clinically stable patients with bipolar disorder (type I: n = 64; type II: n = 44) and healthy controls (n = 86) were assessed with a wide range of cognitive tests measuring executive function, speed, memory, and verbal skills. Data were analysed with multivariate techniques. A distinct subgroup (∼30%) could be identified that performed significantly poorer on tests concerning memory function. This cognitive phenotype subgroup did not differ from the majority of bipolar disorder patients with respect to other demographic or clinical characteristics. Whereas the majority of patients performed similar to controls, a subgroup of patients with bipolar disorder differed substantially from healthy controls in the correlation pattern of low-level cognitive abilities. This suggests that cognitive impairment is not a general trait in bipolar disorder but characteristic of a cognitive subgroup. This has important clinical implications for cognitive rehabilitation and remediation.

  14. [Major depression: features indicative of bipolarity?].

    Science.gov (United States)

    Azorin, J-M

    2011-12-01

    Several recent studies have shown that bipolar disorder is underdiagnosed in patients with major depression. Missing the diagnosis of a bipolar disorder may have serious and even occasionally fatal consequences for a patient with the disease. Moreover misdiagnosis may lead to inappropriate treatment and therefore contribute to worsening medical and functional prognosis. Although there are no pathognomonic characteristics of bipolar depression compared to unipolar depression, evidence-based findings suggest that some features may be indicative of bipolarity, in patients with depression. These features are related to clinical picture of depressive state, course of episode and illness, response to treatment, family history, comorbid conditions, as well as demographic and temperamental characteristics. Based on such features, some authors have proposed operationalized criteria or a diagnostic specific for bipolarity, to identify bipolar depression. Screening instruments may also be used, to facilitate early recognition. Validation studies of these diagnostic features and instruments are underway. Copyright © 2011 L’Encéphale. Published by Elsevier Masson SAS.. All rights reserved.

  15. Bipolar H II regions produced by cloud-cloud collisions

    Science.gov (United States)

    Whitworth, Anthony; Lomax, Oliver; Balfour, Scott; Mège, Pierre; Zavagno, Annie; Deharveng, Lise

    2018-01-01

    We suggest that bipolar H II regions may be the aftermath of collisions between clouds. Such a collision will produce a shock-compressed layer, and a star cluster can then condense out of the dense gas near the center of the layer. If the clouds are sufficiently massive, the star cluster is likely to contain at least one massive star, which emits ionizing radiation, and excites an H II region, which then expands, sweeping up the surrounding neutral gas. Once most of the matter in the clouds has accreted onto the layer, expansion of the H II region meets little resistance in directions perpendicular to the midplane of the layer, and so it expands rapidly to produce two lobes of ionized gas, one on each side of the layer. Conversely, in directions parallel to the midplane of the layer, expansion of the H II region stalls due to the ram pressure of the gas that continues to fall towards the star cluster from the outer parts of the layer; a ring of dense neutral gas builds up around the waist of the bipolar H II region, and may spawn a second generation of star formation. We present a dimensionless model for the flow of ionized gas in a bipolar H II region created according to the above scenario, and predict the characteristics of the resulting free-free continuum and recombination-line emission. This dimensionless model can be scaled to the physical parameters of any particular system. Our intention is that these predictions will be useful in testing the scenario outlined above, and thereby providing indirect support for the role of cloud-cloud collisions in triggering star formation.

  16. Beam loss caused by edge focusing of injection bump magnets and its mitigation in the 3-GeV rapid cycling synchrotron of the Japan Proton Accelerator Research Complex

    Directory of Open Access Journals (Sweden)

    H. Hotchi

    2016-01-01

    Full Text Available In the 3-GeV rapid cycling synchrotron of the Japan Proton Accelerator Research Complex, transverse injection painting is utilized not only to suppress space-charge induced beam loss in the low energy region but also to mitigate foil scattering beam loss during charge-exchange injection. The space-charge induced beam loss is well minimized by the combination of modest transverse painting and full longitudinal painting. But, for sufficiently mitigating the foil scattering part of beam loss, the transverse painting area has to be further expanded. However, such a wide-ranging transverse painting had not been realized until recently due to beta function beating caused by edge focusing of pulsed injection bump magnets during injection. This beta function beating additionally excites random betatron resonances through a distortion of the lattice superperiodicity, and its resultant deterioration of the betatron motion stability causes significant extra beam loss when expanding the transverse painting area. To solve this issue, we newly installed pulse-type quadrupole correctors to compensate the beta function beating. This paper presents recent experimental results on this correction scheme for suppressing the extra beam loss, while discussing the beam loss and its mitigation mechanisms with the corresponding numerical simulations.

  17. Terapia comportamental cognitiva para pessoas com transtorno bipolar Cognitive behavioral therapy for bipolar disorders

    Directory of Open Access Journals (Sweden)

    Francisco Lotufo Neto

    2004-10-01

    Full Text Available Descrição dos objetivos e principais técnicas da terapia comportamental cognitiva usadas para a psicoterapia das pessoas com transtorno bipolar.Objectives and main techniques of cognitive behavior therapy for the treatment of bipolar disorder patients are described.

  18. Terapia comportamental cognitiva para pessoas com transtorno bipolar Cognitive behavioral therapy for bipolar disorders

    OpenAIRE

    Francisco Lotufo Neto

    2004-01-01

    Descrição dos objetivos e principais técnicas da terapia comportamental cognitiva usadas para a psicoterapia das pessoas com transtorno bipolar.Objectives and main techniques of cognitive behavior therapy for the treatment of bipolar disorder patients are described.

  19. Clinical, Demographic, and Familial Correlates of Bipolar Spectrum Disorders among Offspring of Parents with Bipolar Disorder

    Science.gov (United States)

    Goldstein, Benjamin I.; Shamseddeen, Wael; Axelson, David A.; Kalas, Cathy; Monk, Kelly; Brent, David A.; Kupfer, David J.; Birmaher, Boris

    2010-01-01

    Objective: Despite increased risk, most offspring of parents with bipolar disorder (BP) do not manifest BP. The identification of risk factors for BP among offspring could improve preventive and treatment strategies. We examined this topic in the Pittsburgh Bipolar Offspring Study (BIOS). Method: Subjects included 388 offspring, ages 7-17 years,…

  20. Tratamento da depressão bipolar The treatment of bipolar depression

    Directory of Open Access Journals (Sweden)

    Beny Lafer

    2005-01-01

    Full Text Available O tratamento da depressão bipolar tem sido tema de debate. O uso de antidepressivos, principalmente tricíclicos, nestes pacientes está associado a piores desfechos clínicos. Estudos apontam para uma eficácia limitada de estabilizadores tradicionais como lítio, valproato e carbamazepina no tratamento da depressão bipolar. Em casos de depressão mais grave, há indicativos de que os antidepressivos podem ser úteis, sendo recomendado o uso concomitante de um estabilizador do humor. Novos agentes como a lamotrigina têm sido propostos como efetivos no tratamento da depressão bipolar. Estudos recentes utilizando lamotrigina sugerem a sua eficácia e seguraça no tratamento da depressão bipolar.The treatment of bipolar depression has been an area of debate. The use of antidepressants, particularly the triciclics, has been associated with worse clinical outcomes. Evidence points to a limited efficacy of traditional mood stabilizers such as lithium, valproate and carbamazepine in the treatment of bipolar depression. In cases where depression is more severe, there is evidence that antidepressants may be useful. The use of antidepressants should be in association with a mood stabilizer. New agents such as lamotrigine have been put forward as effective in the treatment of bipolar depression. Recent studies using lamotrigine suggest its efficacy and safety in the treatment of bipolar depression.

  1. Subcortical Gray Matter Volume Abnormalities in Healthy Bipolar Offspring: Potential Neuroanatomical Risk Marker for Bipolar Disorder?

    Science.gov (United States)

    Ladouceur, Cecile D.; Almeida, Jorge R. C.; Birmaher, Boris; Axelson, David A.; Nau, Sharon; Kalas, Catherine; Monk, Kelly; Kupfer, David J.; Phillips, Mary L.

    2008-01-01

    A study is conducted to examine the extent to which bipolar disorder (BD) is associated with gray matter volume abnormalities in brain regions in healthy bipolar offspring relative to age-matched controls. Results show increased gray matter volume in the parahippocampus/hippocampus in healthy offspring at genetic risk for BD.

  2. Bipolar lead-acid battery for hybrid electric vehicles

    Energy Technology Data Exchange (ETDEWEB)

    Saakes, M.; Schmal, D.; Veen ter, W.R.; Raadschelders, J.W. [TNO Environment Energy and Process Innovation, Apeldoorn (Netherlands); Have ten, P.T.J.H. [Centurion Accumulatoren B.V., Venlo (Netherlands)

    2000-07-01

    The batteries required for electric vehicles (EV) must possess high range and high specific energy. As far as hybrid electric vehicles (HEV), the battery requirements are quite different and a high power (bipolar) lead-acid battery could represent a viable alternative. It is relatively cheap and benefits from an established recycling infrastructure. The need for such a battery was recognized and work began approximately five years ago on the development of a bipolar lead-acid battery that could be used in pulse power applications. This work was effected at TNO, jointly with the personnel at Centurion, a Dutch manufacturer of lead-acid batteries. The aim of the work was to improve the design, as well as specific power and energy and other characteristics. Two prototypes of 80 V modules were built after several laboratory test cells, and they were then tested with simulated HEV drive cycles. The scientists obtained a specific power of approximately 500 W per kg, therefore doubling the results obtained with the first prototype. The evaluation for the design of the battery that could be mass produced at a reasonable cost is underway. refs., tabs., figs.

  3. [Circadian markers and genes in bipolar disorder].

    Science.gov (United States)

    Yeim, S; Boudebesse, C; Etain, B; Belliviera, F

    2015-09-01

    Bipolar disorder is a severe and complex multifactorial disease, characterized by alternance of acute episodes of depression and mania/hypomania, interspaced by euthymic periods. The etiological determinants of bipolar disorder yet, are still poorly understood. For the last 30 years, chronobiology is an important field of investigation to better understand the pathophysiology of bipolar disorder. We conducted a review using Medline, ISI Database, EMBase, PsyInfo up to January 2015, using the following keywords combinations: "mood disorder", "bipolar disorder", "depression", "unipolar disorder", "major depressive disorder", "affective disorder", for psychiatric conditions; and "circadian rhythms", "circadian markers", "circadian gene", "clock gene", "melatonin" for circadian rhythms. The search critera was presence of word in any field of the article. Quantitative and qualitative circadian abnormalities are associated with bipolar disorders both during acute episodes and euthymic periods, suggesting that these altered circadian rhythms may represent biological trait markers of the disorder. These circadian dysfunctions were assessed by various validated tools including polysomnography, actigraphy, sleep diaries, chronotype assessments and blood melatonin/cortisol measures. Other altered endogenous circadian activities have also been reported in bipolar patients, such as hormones secretion, core body temperature or fibroblasts activity. Moreover, these markers were also altered in healthy relatives of bipolar patients, suggesting a degree of heritability. Several genetic association studies have also showed associations between multiple circadian genes and bipolar disorder, such as CLOCK, ARTNL1, GSK3β, PER3, NPAS2, NR1D1, TIMELESS, RORA, RORB, and CSNK1ε. Thus, these circadian gene variants may contribute to the genetic susceptibility of the disease. Furthermore, the study of the clock system may help to better understand some phenotypic aspects like the

  4. Lay theories of bipolar disorder: the causes, manifestations and cures for perceived bipolar disorder.

    Science.gov (United States)

    Furnham, Adrian; Anthony, Elizabeth

    2010-05-01

    This study aimed to investigate lay theories of the cause and treatment of bipolar disorder, and the recognition of its symptoms. This questionnaire-based study included vignette descriptions of mental disorders and 70 items relating to bipolar disorder. It was completed by 173 participants. Bipolar disorder was recognized less than depression but at the same rate as schizophrenia. Contrary to previous research, analysis showed that lay beliefs of the causes of bipolar disorder generally concur with scientific academic theories. Drug treatment was favoured as a cure rather than psychotherapy. Theories of cause and treatment were logically correlated. Overall, the results suggest that lay people have reasonably informed beliefs about the causes and treatments of bipolar disorder, however recognition of the symptoms is poor.

  5. Around the laboratories: Dubna: Physics results and progress on bubble chamber techniques; Stanford (SLAC): Operation of a very rapid cycling bubble chamber; Daresbury: Photographs of visitors to the Laboratory; Argonne: Charge exchange injection tests into the ZGS in preparation for a proposed Booster

    CERN Multimedia

    1969-01-01

    Around the laboratories: Dubna: Physics results and progress on bubble chamber techniques; Stanford (SLAC): Operation of a very rapid cycling bubble chamber; Daresbury: Photographs of visitors to the Laboratory; Argonne: Charge exchange injection tests into the ZGS in preparation for a proposed Booster

  6. The International Society for Bipolar Disorders (ISBD) Task Force Report on Antidepressant Use in Bipolar Disorders

    Science.gov (United States)

    Pacchiarotti, Isabella; Bond, David J.; Baldessarini, Ross J.; Nolen, Willem A.; Grunze, Heinz; Licht, Rasmus W.; Post, Robert M.; Berk, Michael; Goodwin, Guy M.; Sachs, Gary S.; Tondo, Leonardo; Findling, Robert L.; Youngstrom, Eric A.; Tohen, Mauricio; Undurraga, Juan; González-Pinto, Ana; Goldberg, Joseph F.; Yildiz, Ayşegül; Altshuler, Lori L.; Calabrese, Joseph R.; Mitchell, Philip B.; Thase, Michael E.; Koukopoulos, Athanasios; Colom, Francesc; Frye, Mark A.; Malhi, Gin S.; Fountoulakis, Konstantinos N.; Vázquez, Gustavo; Perlis, Roy H.; Ketter, Terence A.; Cassidy, Frederick; Akiskal, Hagop; Azorin, Jean-Michel; Valentí, Marc; Mazzei, Diego Hidalgo; Lafer, Beny; Kato, Tadafumi; Mazzarini, Lorenzo; Martínez-Aran, Anabel; Parker, Gordon; Souery, Daniel; Özerdem, Ayşegül; McElroy, Susan L.; Girardi, Paolo; Bauer, Michael; Yatham, Lakshmi N.; Zarate, Carlos A.; Nierenberg, Andrew A.; Birmaher, Boris; Kanba, Shigenobu; El-Mallakh, Rif S.; Serretti, Alessandro; Rihmer, Zoltan; Young, Allan H.; Kotzalidis, Georgios D.; MacQueen, Glenda M.; Bowden, Charles L.; Ghaemi, S. Nassir; Lopez-Jaramillo, Carlos; Rybakowski, Janusz; Ha, Kyooseob; Perugi, Giulio; Kasper, Siegfried; Amsterdam, Jay D.; Hirschfeld, Robert M.; Kapczinski, Flávio; Vieta, Eduard

    2014-01-01

    Objective The risk-benefit profile of antidepressant medications in bipolar disorder is controversial. When conclusive evidence is lacking, expert consensus can guide treatment decisions. The International Society for Bipolar Disorders (ISBD) convened a task force to seek consensus recommendations on the use of antidepressants in bipolar disorders. Method An expert task force iteratively developed consensus through serial consensus-based revisions using the Delphi method. Initial survey items were based on systematic review of the literature. Subsequent surveys included new or reworded items and items that needed to be rerated. This process resulted in the final ISBD Task Force clinical recommendations on antidepressant use in bipolar disorder. Results There is striking incongruity between the wide use of and the weak evidence base for the efficacy and safety of antidepressant drugs in bipolar disorder. Few well-designed, long-term trials of prophylactic benefits have been conducted, and there is insufficient evidence for treatment benefits with antidepressants combined with mood stabilizers. A major concern is the risk for mood switch to hypomania, mania, and mixed states. Integrating the evidence and the experience of the task force members, a consensus was reached on 12 statements on the use of antidepressants in bipolar disorder. Conclusions Because of limited data, the task force could not make broad statements endorsing antidepressant use but acknowledged that individual bipolar patients may benefit from antidepressants. Regarding safety, serotonin reuptake inhibitors and bupropion may have lower rates of manic switch than tricyclic and tetracyclic antidepressants and norepinephrine-serotonin reuptake inhibitors. The frequency and severity of antidepressant-associated mood elevations appear to be greater in bipolar I than bipolar II disorder. Hence, in bipolar I patients antidepressants should be prescribed only as an adjunct to mood-stabilizing medications

  7. Drug dreams in outpatients with bipolar disorder and cocaine dependence.

    Science.gov (United States)

    Yee, Tonia; Perantie, Dana C; Dhanani, Nafisa; Brown, E Sherwood

    2004-03-01

    Patients with substance abuse or dependence often have dreams about alcohol or drugs during early recovery. However, the literature on drug dreams in rehabilitating patients with drug-related disorders remains limited. No data are available on drug dreams in people with substance-related disorders and other major mental illness. As part of a large study on the use of lamotrigine in patients with bipolar disorder and cocaine dependence, the frequency and nature of drug dreams, triggers for dreams, and response to the dreams during study participation were assessed in 37 outpatients for as long as 36 weeks. Altogether, 74% of participants experienced at least one drug dream during the study. Furthermore, drug dreams rapidly decreased during study participation. The presence of drug dreams at baseline did not predict mood, cocaine craving, or drug use at exit. No clear risk factors for drug dreams were identified. However, drug dreams were related to survival in the study by a negative U-shaped curve relationship in which those participants with the highest and lowest frequency of drug dreams discontinued from the study the earliest. Content of the dreams frequently included drug use or refusing to use the drug. Dreams of drug use tended to occur during the first few weeks of study participation. Most dreams were associated with triggers for drug use. The findings suggest that drug dreams are common in patients with bipolar disorder and cocaine dependence and are similar in nature to those previously reported in people with pure substance abuse.

  8. Anxiety, stress and perfectionism in bipolar disorder.

    Science.gov (United States)

    Corry, Justine; Green, Melissa; Roberts, Gloria; Frankland, Andrew; Wright, Adam; Lau, Phoebe; Loo, Colleen; Breakspear, Michael; Mitchell, Philip B

    2013-12-01

    Previous reports have highlighted perfectionism and related cognitive styles as a psychological risk factor for stress and anxiety symptoms as well as for the development of bipolar disorder symptoms. The anxiety disorders are highly comorbid with bipolar disorder but the mechanisms that underpin this comorbidity are yet to be determined. Measures of depressive, (hypo)manic, anxiety and stress symptoms and perfectionistic cognitive style were completed by a sample of 142 patients with bipolar disorder. Mediation models were used to explore the hypotheses that anxiety and stress symptoms would mediate relationships between perfectionistic cognitive styles, and bipolar disorder symptoms. Stress and anxiety both significantly mediated the relationship between both self-critical perfectionism and goal attainment values and bipolar depressive symptoms. Goal attainment values were not significantly related to hypomanic symptoms. Stress and anxiety symptoms did not significantly mediate the relationship between self-critical perfectionism and (hypo)manic symptoms. 1. These data are cross-sectional; hence the causality implied in the mediation models can only be inferred. 2. The clinic patients were less likely to present with (hypo)manic symptoms and therefore the reduced variability in the data may have contributed to the null findings for the mediation models with (hypo) manic symptoms. 3. Those patients who were experiencing current (hypo)manic symptoms may have answered the cognitive styles questionnaires differently than when euthymic. These findings highlight a plausible mechanism to understand the relationship between bipolar disorder and the anxiety disorders. Targeting self-critical perfectionism in the psychological treatment of bipolar disorder when there is anxiety comorbidity may result in more parsimonious treatments. © 2013 Published by Elsevier B.V.

  9. Bipolar postpartum depression: An update and recommendations.

    Science.gov (United States)

    Sharma, Verinder; Doobay, Minakshi; Baczynski, Christine

    2017-09-01

    Over the past few years there has been a surge of interest in the study of bipolar postpartum depression (PPD); however, questions remain about its prevalence, screening, clinical features, and treatment. Three electronic databases, MEDLINE/PubMed (1966-2016), PsycINFO (1806-2016), and the Cochrane Database of Systematic Reviews, were searched using a combination of the keywords bipolar, depression, postpartum, peripartum, prevalence, screening, diagnosis, treatment, drugs, and psychotherapy. The reference lists of articles identified were also searched. All relevant articles published in English were included. Depending on the population studied, 21.4-54% of women with PPD have a diagnosis of bipolar disorder (BD). Characteristic clinical features include younger age at illness onset, first onset of depression after childbirth, onset immediately after delivery, atypical depressive symptoms, psychotic features, mixed features, and history of BD in first-degree family members. Treatment should be guided by symptom acuity, safety concerns, the patient's response to past treatments, drug tolerability, and breastfeeding preference. In the absence of controlled treatment data, preference should be given to drugs normally indicated for bipolar depression including lithium, quetiapine and lamotrigine. Although antidepressants have been studied in combination with mood stabilizers in bipolar depression, these drugs should be avoided due to likelihood of elevated risk of induction of manic symptoms in the postpartum period. In the postpartum period, bipolar PPD is common, can be differentiated from unipolar PPD, and needs to be identified promptly in order to expedite appropriate treatment. Future studies on pharmacotherapy and psychotherapy should focus on the acute and preventative treatment of bipolar PPD. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. Estimation of channel characteristics of narrow bipolar events based on the transmission-line model

    Science.gov (United States)

    Zhu, Baoyou; Zhou, Helin; Ma, Ming; Lv, Fanchao; Tao, Shanchang

    2010-10-01

    Narrow bipolar event (NBE) is a distinct class of intracloud lightning discharge, which is associated with the strongest radio frequency emissions and produces typical narrow bipolar radiation field waveforms. On the basis of the transmission-line model, we introduce a direct technique to measure the time taken by the current front to propagate along the channel from distant radiation field pulses; the channel length of the NBE can then be estimated by multiplying this time by an assumed propagation speed. Our method involves integrating over the initial half cycle of narrow bipolar waveform of the NBE. The ratio of the integral result to the initial peak amplitude makes a good approximation to the time taken by the current front to travel along the channel, even though the current amplitude suffers heavy attenuation along the propagating channel. This method can be applied to all NBEs which produce narrow bipolar radiation field waveforms. Besides, if both the far radiation field and the near-electrostatic field measurements were available, one could combine the method here and that of Eack (2004) to obtain the channel length of the NBE.

  11. MLL5 maintains spindle bipolarity by preventing aberrant cytosolic aggregation of PLK1.

    Science.gov (United States)

    Zhao, Wei; Liu, Jie; Zhang, Xiaoming; Deng, Lih-Wen

    2016-03-28

    Faithful chromosome segregation with bipolar spindle formation is critical for the maintenance of genomic stability. Perturbation of this process often leads to severe mitotic failure, contributing to tumorigenesis. MLL5 has been demonstrated to play vital roles in cell cycle progression and the maintenance of genomic stability. Here, we identify a novel interaction between MLL5 and PLK1 in the cytosol that is crucial for sustaining spindle bipolarity during mitosis. Knockdown of MLL5 caused aberrant PLK1 aggregation that led to acentrosomal microtubule-organizing center (aMTOC) formation and subsequent spindle multipolarity. Further molecular studies revealed that the polo-box domain (PBD) of PLK1 interacted with a binding motif on MLL5 (Thr887-Ser888-Thr889), and this interaction was essential for spindle bipolarity. Overexpression of wild-type MLL5 was able to rescue PLK1 mislocalization and aMTOC formation in MLL5-KD cells, whereas MLL5 mutants incapable of interacting with the PBD failed to do so. We thus propose that MLL5 preserves spindle bipolarity through maintaining cytosolic PLK1 in a nonaggregated form. © 2016 Zhao et al.

  12. Early physical and sexual abuse associated with an adverse course of bipolar illness.

    Science.gov (United States)

    Leverich, Gabriele S; McElroy, Susan L; Suppes, Trisha; Keck, Paul E; Denicoff, Kirk D; Nolen, Willem A; Altshuler, Lori L; Rush, A John; Kupka, Ralph; Frye, Mark A; Autio, Karen A; Post, Robert M

    2002-02-15

    There is growing awareness of the association between physical and sexual abuse and subsequent development of psychopathology, but little is known, however, about their relationship to the longitudinal course of bipolar disorder. We evaluated 631 outpatients with bipolar I or II disorder for general demographics, a history of physical or sexual abuse as a child or adolescent, course of illness variables, and prior suicide attempts, as well as SCID-derived Axis I and patient endorsed Axis II comorbidity. Those who endorsed a history of child or adolescent physical or sexual abuse, compared with those who did not, had a history of an earlier onset of bipolar illness, an increased number of Axis I, II, and III comorbid disorders, including drug and alcohol abuse, faster cycling frequencies, a higher rate of suicide attempts, and more psychosocial stressors occurring before the first and most recent affective episode. The retrospectively reported associations of early abuse with a more severe course of illness were validated prospectively. Greater appreciation of the association of early traumatic experiences and an adverse course of bipolar illness should lead to preventive and early intervention approaches that may lessen the associated risk of a poor outcome.

  13. Dopamine dysregulation syndrome: implications for a dopamine hypothesis of bipolar disorder.

    Science.gov (United States)

    Berk, M; Dodd, S; Kauer-Sant'anna, M; Malhi, G S; Bourin, M; Kapczinski, F; Norman, T

    2007-01-01

    Rational therapeutic development in bipolar is hampered by a lack of pathophysiological model. However, there is a wealth of converging data on the role of dopamine in bipolar disorder. This paper therefore examines the possibility of a dopamine hypothesis for bipolar disorder. A literature search was conducted using standard search engines Embase, PyschLIT, PubMed and MEDLINE. In addition, papers and book chapters known to the authors were retrieved and examined for further relevant articles. Collectively, in excess of 100 articles were reviewed from which approximately 75% were relevant to the focus of this paper. Pharmacological models suggest a role of increased dopaminergic drive in mania and the converse in depression. In Parkinson's disease, administration of high-dose dopamine precursors can produce a 'maniform' picture, which switches into a depressive analogue on withdrawal. It is possible that in bipolar disorder there is a cyclical process, where increased dopaminergic transmission in mania leads to a secondary down regulation of dopaminergic receptor sensitivity over time. This may lead to a period of decreased dopaminergic transmission, corresponding with the depressive phase, and the repetition of the cycle. This model, if verified, may have implications for rational drug development.

  14. Immune activation by casein dietary antigens in bipolar disorder

    NARCIS (Netherlands)

    Severance, E.G.; Dupont, D.; Dickerson, F.B.; Stallings, C.R.; Origoni, A.E.; Krivogorsky, B.; Yang, S.; Haasnoot, W.; Yolken, R.H.

    2010-01-01

    Objectives: Inflammation and other immune processes are increasingly linked to psychiatric diseases. Antigenic triggers specific to bipolar disorder are not yet defined. We tested whether antibodies to bovine milk caseins were associated with bipolar disorder, and whether patients recognized

  15. A minimum thermodynamic model for the bipolar seesaw

    DEFF Research Database (Denmark)

    Stocker, Thomas F.; Johnsen, Sigfus Johann

    2003-01-01

    Bipolar seesaw, synchronization of Antarctic and Greenland ice cores, Dansgaard-Oeschger events, north-south connection......Bipolar seesaw, synchronization of Antarctic and Greenland ice cores, Dansgaard-Oeschger events, north-south connection...

  16. Bipolar disorder: an update | Outhoff | South African Family Practice

    African Journals Online (AJOL)

    Bipolar disorder, characterised by alternating discrete episodes of (hypo)mania and depression, provides unique diagnostic and treatment challenges. Updated diagnostic (DSM-5) and current pharmacological treatment recommendations are briefly reviewed here. Keywords: bipolar disorder; diagnosis; evidence-based ...

  17. Assessment of subjective and objective cognitive function in bipolar disorder

    DEFF Research Database (Denmark)

    Demant, Kirsa M; Vinberg, Maj; Kessing, Lars V

    2015-01-01

    Cognitive dysfunction is prevalent in bipolar disorder (BD). However, the evidence regarding the association between subjective cognitive complaints, objective cognitive performance and psychosocial function is sparse and inconsistent. Seventy seven patients with bipolar disorder who presented...

  18. Bipolar resistive switching in Si/Ag nanostructures

    Science.gov (United States)

    Dias, C.; Lv, H.; Picos, R.; Aguiar, P.; Cardoso, S.; Freitas, P. P.; Ventura, J.

    2017-12-01

    Resistive switching devices are being intensively studied aiming a large number of promising applications such as nonvolatile memories, artificial neural networks and sensors. Here, we show nanoscale bipolar resistive switching in Pt/Si/Ag/TiW structures, with a dielectric barrier thickness of 20 nm. The observed phenomenon is based on the formation/rupture of metallic Ag filaments in the otherwise insulating Si host material. No electroforming process was required to achieve resistive switching. We obtained average values of 0.23 V and -0.24 V for the Set and Reset voltages, respectively. The stability of the switching was observed for over 100 cycles, together with a clear separation of the ON (103 Ω) and OFF (102 Ω) states. Furthermore, the influence of the Set current compliance on the ON resistance, resistances ratio and Set/Reset voltages percentage variation was also studied.

  19. Big data for bipolar disorder.

    Science.gov (United States)

    Monteith, Scott; Glenn, Tasha; Geddes, John; Whybrow, Peter C; Bauer, Michael

    2016-12-01

    The delivery of psychiatric care is changing with a new emphasis on integrated care, preventative measures, population health, and the biological basis of disease. Fundamental to this transformation are big data and advances in the ability to analyze these data. The impact of big data on the routine treatment of bipolar disorder today and in the near future is discussed, with examples that relate to health policy, the discovery of new associations, and the study of rare events. The primary sources of big data today are electronic medical records (EMR), claims, and registry data from providers and payers. In the near future, data created by patients from active monitoring, passive monitoring of Internet and smartphone activities, and from sensors may be integrated with the EMR. Diverse data sources from outside of medicine, such as government financial data, will be linked for research. Over the long term, genetic and imaging data will be integrated with the EMR, and there will be more emphasis on predictive models. Many technical challenges remain when analyzing big data that relates to size, heterogeneity, complexity, and unstructured text data in the EMR. Human judgement and subject matter expertise are critical parts of big data analysis, and the active participation of psychiatrists is needed throughout the analytical process.

  20. [Ramadan and bipolar disorder: Example of circadian rhythm disturbance and its impact on patients with bipolar disorders].

    Science.gov (United States)

    Eddahby, S; Kadri, N; Moussaoui, D

    2013-09-01

    Fasting during the Ramadan month is a cornerstone of Islam. Several disorders of the chronobiological rhythms occur during this month and impact on mood. Through this paper the authors provide a literature review of the impact of fasting on patients with bipolar disorders. A literature review using Mesh keywords through Medline database. From 1970 to 2011, articles in French and English were selected. Circadian rhythm refers to the approximately 24-hour cycles that are generated by an organism. Most physiological systems demonstrate circadian variations. Many hormones and other metabolisms, such as gastric pH, insulin, glucose, calcium and plasmatic gastrine, have been shown to exhibit circadian oscillation. The role of social rhythm in behaviors and its influence on circadian rhythms in humans is now obvious. It has been shown that the lack of concentration and irritability increased continuously during Ramadan month and reached its peak at the end of the month. Mood and vigilance are significantly decreased during the fasting month. Several authors have stated that the course of bipolar illness may be affected by the changes in social rhythm that occur during Ramadan (fasting month). Studies which have been devoted to this topic are sparse. Kadri et al., in 2000, studied 20 bipolar patients during the fasting month of Ramadan of 1417 (Hegirian calendar, corresponding to January 1997). Diagnosis of bipolar disorder was made according to ICD-10 criteria. Patients were assessed during the week before Ramadan, the second and the fourth weeks of the fasting month and the first week after its end, with the Hamilton Depression and Bech-Rafaelsen scales. The plasma concentration of lithium was also assessed. The main finding of the study was that 45% of the patients relapsed, 70% during the second week, and the remaining patients at the end of Ramadan. These relapses were not related to plasma concentration of lithium. Most of the relapses were manic (71

  1. Voltage regulator for battery power source. [using a bipolar transistor

    Science.gov (United States)

    Black, J. M. (Inventor)

    1979-01-01

    A bipolar transistor in series with the battery as the control element also in series with a zener diode and a resistor is used to maintain a predetermined voltage until the battery voltage decays to very nearly the predetermined voltage. A field effect transistor between the base of the bipolar transistor and a junction between the zener diode and resistor regulates base current of the bipolar transistor, thereby regulating the conductivity of the bipolar transistor for control of the output voltage.

  2. Cytokines in bipolar disorder vs. healthy control subjects

    DEFF Research Database (Denmark)

    Munkholm, Klaus; Braüner, Julie Vestergaard; Kessing, Lars Vedel

    2013-01-01

    Bipolar disorder may be associated with peripheral immune system dysfunction; however, results in individual studies are conflicting. Our aim was to systematically review evidence of peripheral cytokine alterations in bipolar disorder integrating findings from various affective states.......Bipolar disorder may be associated with peripheral immune system dysfunction; however, results in individual studies are conflicting. Our aim was to systematically review evidence of peripheral cytokine alterations in bipolar disorder integrating findings from various affective states....

  3. Beam-based compensation of extracted-beam displacement caused by field ringing of pulsed kicker magnets in the 3 GeV rapid cycling synchrotron of the Japan Proton Accelerator Research Complex

    Science.gov (United States)

    Harada, Hiroyuki; Saha, Pranab Kumar; Tamura, Fumihiko; Meigo, Shin-ichiro; Hotchi, Hideaki; Hayashi, Naoki; Kinsho, Michikazu; Hasegawa, Kazuo

    2017-09-01

    Commissioned in October 2007, the 3 GeV rapid cycling synchrotron (RCS) of the Japan Proton Accelerator Research Complex was designed for a high-intensity output beam power of 1 MW. The RCS extracts 3 GeV proton beams of two bunches by using eight pulsed kicker magnets and three DC septum magnets with 25 Hz repetition. These beams are delivered to a materials and life science experimental facility (MLF) and a 50 GeV main ring synchrotron (MR). However, the flat-top fields of the kicker magnets experience ringing that displaces the position of the extracted beam. This displacement is a major issue from the viewpoint of target integrity at the MLF and emittance growth at MR injection. To understand the flat-top uniformity of the total field of all the kickers, the uniformity was measured as the displacement of the extracted beams by using a shorter bunched beam and scanning the entire trigger timing of the kickers. The beam displacement of the first bunch exceeded the required range. Therefore, we performed beam-based measurements kicker by kicker to understand each field-ringing effect, and then we understood the characteristics (strength and temporal structure) of each ringing field. We managed to cancel out the ringing by using all the beam-based measurement data and optimizing each trigger timing. As a result, the field-ringing effect of the kickers was successfully compensated by optimizing the trigger timing of each kicker without hardware upgrades or improvements to the kicker system. By developing an automatic monitoring and correction system, we now have a higher stability of extracted beams during routine user operation. In this paper, we report our procedure for ringing compensation and present supporting experimental results.

  4. Modeling bipolar stimulation of cardiac tissue

    Science.gov (United States)

    Galappaththige, Suran K.; Gray, Richard A.; Roth, Bradley J.

    2017-09-01

    Unipolar stimulation of cardiac tissue is often used in the design of cardiac pacemakers because of the low current required to depolarize the surrounding tissue at rest. However, the advantages of unipolar over bipolar stimulation are not obvious at shorter coupling intervals when the tissue near the pacing electrode is relatively refractory. Therefore, this paper analyzes bipolar stimulation of cardiac tissue. The strength-interval relationship for bipolar stimulation is calculated using the bidomain model and a recently developed parsimonious ionic current model. The strength-interval curves obtained using different electrode separations and arrangements (electrodes placed parallel to the fibers versus perpendicular to the fibers) indicate that bipolar stimulation results in more complex activation patterns compared to unipolar stimulation. An unusually low threshold stimulus current is observed when the electrodes are close to each other (a separation of 1 mm) because of break excitation. Unlike for unipolar stimulation, anode make excitation is not present during bipolar stimulation, and an abrupt switch from anode break to cathode make excitation can cause dramatic changes in threshold with very small changes in the interval. These results could impact the design of implantable pacemakers and defibrillators.

  5. Bipolar magnetic semiconductor in silicene nanoribbons

    Energy Technology Data Exchange (ETDEWEB)

    Farghadan, Rouhollah, E-mail: rfarghadan@kashanu.ac.ir

    2017-08-01

    Highlights: • A new electronic phase for silicene nanoribbon in the presence of electric and magnetic fields. • Bipolar magnetic semiconductor with controllable spin-flip and spin-conserved gaps in silicene. • Robust bipolar magnetic semiconductor features in a rough silicene. • Perfect and reversible spin polarization in silicene nanoribbon junctions. - Abstract: A theoretical study was presented on generation of spin polarization in silicene nanoribbons using the single-band tight-binding approximation and the non-equilibrium Green’s function formalism. We focused on the effect of electric and exchange magnetic fields on the spin-filter capabilities of zigzag-edge silicene nanoribbons in the presence of the intrinsic spin-orbit interaction. The results show that a robust bipolar magnetic semiconductor with controllable spin-flip and spin-conserved gaps can be obtained when exchange magnetic and electric field strengths are both larger than the intrinsic spin-orbit interaction. Therefore, zigzag silicene nanoribbons could act as bipolar and perfect spin filter devices with a large spin-polarized current and a reversible spin polarization in the vicinity of the Fermi energy. We also investigated the effect of edge roughness and found that the bipolar magnetic semiconductor features are robust against edge disorder in silicene nanoribbon junctions. These results may be useful in multifunctional spin devices based on silicene nanoribbons.

  6. [Drug Abuse Comorbidity in Bipolar Disorder].

    Science.gov (United States)

    Ortiz, Óscar Medina

    2012-06-01

    Drug use among patients with bipolar disorder is greater than the one observed in the general population; psychotic episodes are likely to occur after consumption. This has implications in the prevention, etiology, management, and treatment of the disease. Bipolar disorder pathology is likely to have positive response to pharmacological treatment. Therefore, identifying the strategies with better results to be applied in these patients is fundamental for psychiatrists and primary care physicians. Review literature in order to determine the prevalence and characteristics of drug abuse in patients with bipolar disorder and establish the pharmacological strategies that have produced better results. Literature review. A great variety of studies demonstrate the relationship between bipolar disorder and drug use disorder. These patients are hospitalized more frequently, have an earlier onset of the disease, and present a larger number of depressive episodes and suicide attempts which affect the course of the disease. The drug with better results in the treatment of these patients is Divalproate. Satisfactory results have been also obtained with other mood stabilizers such as carbamazepine, lamotrigine, and the antipsychotic aripiprazole. Substance abuse is present in a large number of patients with bipolar disorder. The Divalproate is the drug that has shown better results in the studies. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  7. Predictors of trait aggression in bipolar disorder.

    Science.gov (United States)

    Garno, Jessica L; Gunawardane, Nisali; Goldberg, Joseph F

    2008-03-01

    Although aggressive behavior has been associated with bipolar disorder (BD), it has also been linked with developmental factors and disorders frequently found to be comorbid with BD, making it unclear whether or not it represents an underlying biological disturbance intrinsic to bipolar illness. We therefore sought to identify predictors of trait aggression in a sample of adults with BD. Subjects were 100 bipolar I (n = 73) or II (n = 27) patients consecutively evaluated in the Bipolar Disorders Research Program of the New York Presbyterian Hospital-Payne Whitney Clinic. Diagnoses were established using the Structured Clinical Interview for the DSM-IV (SCID-I) and Cluster B sections of the SCID-II. Mood severity was rated by the Hamilton Depression Rating Scale (HDRS) and Young Mania Rating Scale (YMRS). Histories of childhood maltreatment were assessed via the Childhood Trauma Questionnaire (CTQ), while trait aggression was measured by the Brown-Goodwin Aggression Scale (BGA). In univariate analyses, significant relationships were observed between total BGA scores and CTQ total (r = 0.326, p = 0.001), childhood emotional abuse (r = 0.417, p aggression was significantly associated with: (i) diagnoses of comorbid borderline personality disorder (p aggression in BD, while controlling for confounding factors. The findings have implications for nosologic distinctions between bipolar and borderline personality disorders, and the developmental pathogenesis of comorbid personality disorders as predisposing to aggression in patients with BD.

  8. Toward stratified treatments for bipolar disorders.

    Science.gov (United States)

    Hasler, Gregor; Wolf, Andreas

    2015-03-01

    In bipolar disorders, there are unclear diagnostic boundaries with unipolar depression and schizophrenia, inconsistency of treatment guidelines, relatively long trial-and-error phases of treatment optimization, and increasing use of complex combination therapies lacking empirical evidence. These suggest that the current definition of bipolar disorders based on clinical symptoms reflects a clinically and etiologically heterogeneous entity. Stratification of treatments for bipolar disorders based on biomarkers and improved clinical markers are greatly needed to increase the efficacy of currently available treatments and improve the chances of developing novel therapeutic approaches. This review provides a theoretical framework to identify biomarkers and summarizes the most promising markers for stratification regarding beneficial and adverse treatment effects. State and stage specifiers, neuropsychological tests, neuroimaging, and genetic and epigenetic biomarkers will be discussed with respect to their ability to predict the response to specific pharmacological and psychosocial psychotherapies for bipolar disorders. To date, the most reliable markers are derived from psychopathology and history-taking, while no biomarker has been found that reliably predicts individual treatment responses. This review underlines both the importance of clinical diagnostic skills and the need for biological research to identify markers that will allow the targeting of treatment specifically to sub-populations of bipolar patients who are more likely to benefit from a specific treatment and less likely to develop adverse reactions. Copyright © 2015 Elsevier B.V. and ECNP. All rights reserved.

  9. Development and testing of a bipolar lead-acid battery for hybrid electric vehicles

    Energy Technology Data Exchange (ETDEWEB)

    Saakes, M.; Kluiters, E.; Schmal, D. [TNO Inst. of Environmental Sciences, Energy Research and Process Innovation, Apeldoorn (Netherlands); Mourad, S. [TNO Road-Vehicles Research Inst., Delft (Netherlands); Have, P.T.J.H. ten [Centurion Accumulatoren, Venlo (Netherlands)

    1999-03-01

    An 80 V bipolar lead-acid battery was constructed and tested using hybrid electric vehicle (HEV) drive cycles. Drive cycles with a peak power of 6.7 kW, equal to 1/5 of the total power profile required for the HEV studied, were run successfully. Model calculations showed that the 80 V module constructed, which is at the moment 2.5 times heavier than required for the HEV operation studied, can be optimised to meet the requirements. (orig.)

  10. Tell me your apps and I will tell you your mood: Correlation of apps usage with Bipolar Disorder State

    DEFF Research Database (Denmark)

    Alvarez-Lozano, Jorge; Frost, Mads; Osmani, Venet

    2014-01-01

    Bipolar Disorder is a disease that is manifested with cycling periods of polar episodes, namely mania and depression. Depressive episodes are manifested through disturbed mood, psychomotor retardation, behaviour change, decrease in energy levels and length of sleep. Manic episodes are manifested...... through elevated mood, psychomotor acceleration and increase in intensity of social interactions. In this paper we report results of a clinical trial with bipolar patients that amongst other aspects, investigated whether changes in general behaviour of patients due to onset of a bipolar episode, can...... behaviour before the psychiatric evaluation and after the psychiatric evaluation. The results show that patients have strong correlation of patterns of app usage with different aspects of their self-reported state including mood, sleep and irritability. While, on the other hand, the patients’ application...

  11. Coping and personality in older patients with bipolar disorder

    NARCIS (Netherlands)

    Schouws, S.N.T.M.; Paans, N.P.G.; Comijs, H.C.; Dols, A.; Stek, M.L.

    2015-01-01

    Abstract Background Little is known about coping styles and personality traits in older bipolar patients. Adult bipolar patients show a passive coping style and higher neuroticism scores compared to the general population. Our aim is to investigate personality traits and coping in older bipolar

  12. Concurrent hypokalemic periodic paralysis and bipolar disorder

    Directory of Open Access Journals (Sweden)

    Chia-Lin Lin

    2015-01-01

    Full Text Available Primary periodic paralysis is a rare autosomal dominant disorder of ion-channel dysfunction, manifested by episodic flaccid paresis secondary to abnormal sarcolemma excitability. Membrane destabilization involving Na, K-ATPase has been hypothesized to be a biological etiology of the bipolar disorder (BD and the mechanisms underlying lithium therapy have been linked to it. To date, there has been only one reported case of BD comorbid with periodic paralysis. Herein, we reported another case of concurrent bipolar mania and hypokalemic periodic paralysis (HPP, one special form of periodic paralysis. Consistent with the previous case, our patient responded well to lithium treatment for both bipolar mania and HPP. This might provide some support to the hypothesis that the therapeutic effects of lithium in both BD and HPP could be due to the correction of the underlying common pathophysiology.

  13. Fenomenologia do tempo vivido no transtorno bipolar

    Directory of Open Access Journals (Sweden)

    Virginia Moreira

    Full Text Available Com base na tradição da psicopatologia fenomenológica, este artigo se propõe a contribuir para a compreensão do mundo vivido do paciente bipolar, marcado por uma forte alteração do tempo vivido. Realizamos uma descrição deste tempo vivido significado de forma diferente nas oscilações de humor chamadas de fase maníaca e fase melancólica. Pensado a partir da temporalidade, na fase melancólica, o bipolar parece parar no tempo, não se lança em um devir. Na fase maníaca, o sujeito vive demasiadamente um agora como se tivesse explodido sua biografia. Concluímos que estas fases, ou dois pólos opostos no funcionamento temporal patológico do sofrimento bipolar, constituem fundamentalmente um mesmo mundo vivido.

  14. [Bipolar disorders in oncology: Characteristics and management].

    Science.gov (United States)

    Reich, Michel; Kotecki, Nuria

    2017-05-01

    Bipolar disorders belong to the spectrum of mood disorders and represent a serious psychiatric comorbidity. Behaviors adopted by bipolar patients can foster cancer occurrence but also impact its management, especially during acute depressive or manic episode. Oncologists must adapt their protocols in order to obtain the best compliance for treatment and avoid any possible mood destabilization, with the inherent risk of suicidal attempt. Potential interactions between mood-stabilizing agents (lithium, divalproate, atypical antipsychotics, and anticonvulsivants) and oncologic treatment (chemotherapy, targeted therapy, immunotherapy, corticotherapy) will be particularly watched. To do so, a closely collaboration with the oncopsychiatrist but also with the referent or liaison psychiatry team is necessary during the patient's oncologic care. Some clinical vignettes will illustrate the modalities of care of bipolar disorders in oncology. Copyright © 2017 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

  15. Exercise in bipolar patients: A systematic review.

    Science.gov (United States)

    Melo, Matias Carvalho Aguiar; Daher, Elizabeth De Francesco; Albuquerque, Saulo Giovanni Castor; de Bruin, Veralice Meireles Sales

    2016-07-01

    Sedentary lifestyle is frequent in psychiatric disorders, however the directions of this association and benefits of physical activity are unclear. This is a systematic review about exercise in patients with bipolar disorder. We performed a systematic literature search of studies published in English (1995 Jan to 2016 Jan) in PubMed, and Cochrane Library combining the medical terms 'physical activity' or 'sedentary' or 'physical exercise' with 'bipolar disorder' or 'mania' or 'bipolar depression'. Thirty-one studies were selected and included 15,587 patients with bipolar disorder. Sedentary lifestyle varied from 40% to 64.9%. Physical activity was associated with less depressive symptoms, better quality of life and increased functioning. Some evidence indicates a relationship between vigorous exercises and mania. Three prospective cohorts were reported; and no prospective randomized controlled trial was identified. Three studies focused on biomarkers in bipolar patients; and one reported the relationship between exercise and sleep in this group. Two assessed physical exercise in adolescents. (1) Differences between studies preventing a unified analysis; (2) most studies were cross-sectional; (3) motivation for exercising is a selection bias in most studies; (4) no intervention study assessing only physical exercise; (5) lack of studies comparing exercise across mood states. Generally, exercise was associated with improved health measures including depressive symptoms, functioning and quality of life. Evidence was insufficient to establish a cause-effect relationship between mood and physical exercise. Future research including randomized trials is needed to clarify the role of physical activity in bipolar patients. Copyright © 2016 Elsevier B.V. All rights reserved.

  16. A report on older-age bipolar disorder from the International Society for Bipolar Disorders Task Force

    DEFF Research Database (Denmark)

    Sajatovic, Martha; Strejilevich, Sergio A; Gildengers, Ariel G

    2015-01-01

    OBJECTIVES: In the coming generation, older adults with bipolar disorder (BD) will increase in absolute numbers as well as proportion of the general population. This is the first report of the International Society for Bipolar Disorder (ISBD) Task Force on Older-Age Bipolar Disorder (OABD). METHODS...

  17. Three times more days depressed than manic or hypomanic in both bipolar I and bipolar II disorder

    NARCIS (Netherlands)

    Kupka, Ralph W.; Altshuler, Lori L.; Nolen, Willem A.; Suppes, Trisha; Luckenbaugh, David A.; Leverich, Gabriele S.; Frye, Mark A.; Keck, Paul E.; McElroy, Susan L.; Grunze, Heinz; Post, Robert M.

    Objectives: To assess the proportion of time spent in mania, depression and euthymia in a large cohort of bipolar subjects studied longitudinally, and to investigate depression/mania ratios in patients with bipolar I versus bipolar II disorder. Methods: Clinician-adjusted self-ratings of mood were

  18. Emotion regulation deficits in euthymic bipolar I versus bipolar II disorder: a functional and diffusion-tensor imaging study.

    Science.gov (United States)

    Caseras, Xavier; Murphy, Kevin; Lawrence, Natalia S; Fuentes-Claramonte, Paola; Watts, Jessica; Jones, Derek K; Phillips, Mary L

    2015-08-01

    Emotion regulation deficits are a core feature of bipolar disorder. However, their potential neurobiological underpinnings and existence beyond bipolar I disorder remain unexplored. Our main goal was to investigate whether both individuals with bipolar I and bipolar II disorder show deficits in emotion regulation during an attention control task, and to explore the neurophysiological underpinnings of this potential deficit. Twenty healthy controls, 16 euthymic participants with bipolar I disorder, and 19 euthymic participants with bipolar II disorder completed psychometric and clinical assessments, a neuroimaging emotion regulation paradigm, and an anatomical diffusion-weighted scan. Groups were matched for age, gender, and verbal IQ. During the presence of emotional distracters, subjects with bipolar I disorder showed slowed reaction times to targets, and increased blood oxygenation level-dependent (BOLD) responses in the amygdala, accumbens, and dorsolateral prefrontal cortex, but not increased inverse functional connectivity between these prefrontal and subcortical areas, and altered white matter microstructure organization in the right uncinate fasciculus. Subjects with bipolar II disorder showed no altered reaction times, increased BOLD responses in the same brain areas, increased inverse functional connectivity between the prefrontal cortex and amygdala, and no abnormalities in white matter organization. Participants with bipolar I disorder showed abnormalities in functional and anatomical connectivity between prefrontal cortices and subcortical structures in emotion regulation circuitry. However, these deficits did not extend to subjects with bipolar II disorder, suggesting fundamental differences in the pathophysiology of bipolar disorder subtypes. © 2015 The Authors. Bipolar Disorders Published by John Wiley & Sons Ltd.

  19. Alcoholism and anxiety in bipolar illness : Differential lifetime anxiety comorbidity in bipolar I women with and without alcoholism

    NARCIS (Netherlands)

    Levander, Eric; Frye, Mark A.; McElroy, Susan; Suppes, Trisha; Grunze, Heinz; Nolen, Willem A.; Kupka, Ralph; Keck, Paul E.; Leverich, Gabriele S.; Altshuler, Lori L.; Hwang, Sun; Mintz, Jim; Post, Robert M.

    Introduction: This study was undertaken to evaluate the prevalence rate of anxiety comorbidity in bipolar subjects with and without alcohol use disorders (AUD). Methods: Bipolar men and women who entered the Stanley Foundation Bipolar Network (SFBN) underwent a Structured Clinical Interview for

  20. Methodological recommendations for cognition trials in bipolar disorder by the International Society for Bipolar Disorders Targeting Cognition Task Force

    DEFF Research Database (Denmark)

    Miskowiak, K W; Burdick, K E; Martinez-Aran, A

    2017-01-01

    OBJECTIVES: To aid the development of treatment for cognitive impairment in bipolar disorder, the International Society for Bipolar Disorders (ISBD) convened a task force to create a consensus-based guidance paper for the methodology and design of cognition trials in bipolar disorder. METHODS: Th...

  1. [Psychology and psychotherapy in bipolar disorder].

    Science.gov (United States)

    Kupka, R W; de Been, D

    2006-01-01

    This essay presents recent insights and theories relating to the various psychological mechanisms underlying bipolar disorder and describes a number of the psychotherapies that are based on these mechanisms. Each type of psychotherapy derives from the assumption that bipolar disorder has a neurobiological origin and all the psychotherapies involve long-term pharmacotherapy and comprise many psychoeducational elements. The psychotherapies complement each other and the best and most useful parts of one therapy can be combined with those of others in everyday practice. Patients participating in these psychotherapies can obtain additional support from self help manuals.

  2. Biogeochemical Cycling

    Science.gov (United States)

    Bebout, Brad; Fonda, Mark (Technical Monitor)

    2002-01-01

    This lecture will introduce the concept of biogeochemical cycling. The roles of microbes in the cycling of nutrients, production and consumption of trace gases, and mineralization will be briefly introduced.

  3. Administration of ketamine for unipolar and bipolar depression.

    Science.gov (United States)

    Kraus, Christoph; Rabl, Ulrich; Vanicek, Thomas; Carlberg, Laura; Popovic, Ana; Spies, Marie; Bartova, Lucie; Gryglewski, Gregor; Papageorgiou, Konstantinos; Lanzenberger, Rupert; Willeit, Matthäus; Winkler, Dietmar; Rybakowski, Janusz K; Kasper, Siegfried

    2017-03-01

    Clinical trials demonstrated that ketamine exhibits rapid antidepressant efficacy when administered in subanaesthetic dosages. We reviewed currently available literature investigating efficacy, response rates and safety profile. Twelve studies investigating unipolar, seven on bipolar depression were included after search in medline, scopus and web of science. Randomized, placebo-controlled or open-label trials reported antidepressant response rates after 24 h on primary outcome measures at 61%. The average reduction of Hamilton Depression Rating Scale (HAM-D) was 10.9 points, Beck Depression Inventory (BDI) 15.7 points and Montgomery-Asberg Depression Rating Scale (MADRS) 20.8 points. Ketamine was always superior to placebo. Most common side effects were dizziness, blurred vision, restlessness, nausea/vomiting and headache, which were all reversible. Relapse rates ranged between 60% and 92%. To provide best practice-based information to patients, a consent-form for application and modification in local language is included. Ketamine constitutes a novel, rapid and efficacious treatment option for patients suffering from treatment resistant depression and exhibits rapid and significant anti-suicidal effects. New administration routes might serve as alternative to intravenous regimes for potential usage in outpatient settings. However, long-term side effects are not known and short duration of antidepressant response need ways to prolong ketamine's efficacy.

  4. Cognitive style in bipolar disorder sub-types.

    Science.gov (United States)

    Fletcher, Kathryn; Parker, Gordon; Manicavasagar, Vijaya

    2013-04-30

    Clearer understanding of psychological processes and mechanisms such as cognitive style inform more targeted psychological treatments for mood disorders. Studies to date have focused on bipolar I disorder or combined bipolar sub-types, precluding identification of any distinctive cognitive style profiles. We examined cognitive style separately in the bipolar sub-types, contrasted with unipolar and non-clinical controls. A total of 417 participants (94 bipolar I, 114 bipolar II, 109 unipolar, 100 healthy controls) completed cognitive style measures including the Rosenberg Self-Esteem Scale, Dysfunctional Attitudes Scale, Inferential Styles Questionnaire, Stress Appraisal Measure and the Behavioural Inhibition System/Behavioural Activation System Scale. Overall, cognitive styles were similar in unipolar and bipolar participants, but with styles relevant to the Behavioral Activation System differentiating bipolar I disorder in particular. State anxiety influenced negative inferential style in unipolar participants and appraisal of stress in bipolar II participants. Analyses restricted to bipolar I vs. II comparisons revealed subtle differences in terms of dispositional stress appraisal, with higher scores on two stress appraisal sub-scales in the bipolar I group. Further exploration of cognitive style in bipolar sub-types is indicated in order to determine whether there are specific psychological vulnerabilities that would benefit from more targeted psychological interventions. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  5. Sleep disturbances in pediatric bipolar disorder: A comparison between Bipolar I and Bipolar NOS

    Directory of Open Access Journals (Sweden)

    Argelinda eBaroni

    2012-03-01

    Full Text Available Introduction: The diagnosis of Bipolar Disorder (BD in youths has been controversial, especially for the subtype BD Not Otherwise Specified (BD-NOS. In spite of growing evidence that sleep is a core feature of BD, few studies characterize and compare sleep disturbances in youth with BD type I (BD-I and BD-NOS. Sleep disturbances are frequently reported in clinical descriptions of children and adolescents with BD, however the reporting of the frequency and characteristics of sleep symptoms in youth with BD NOS and BD I during episodes remain poor. This study compares symptom of sleep disturbance as occurring in manic and depressive episodes in BD I and BD NOS youth using KSADS-PL interview data. The study also addresses whether symptoms of sleep disturbance vary in different age groups. Material and Methods: The sample consisted of 70 children and adolescent outpatients at an urban specialty clinic (42M/28F, 10.8±3.6 years old including 24 BP-I and 46 BP-NOS assessed using K-SADS-PL-parent interview. Results: Sleep disturbances including insomnia and decreased need for sleep were reported by 84.3% of the sample. Enuresis was diagnosed in 27% of sample. There were no significant differences in frequency of sleep symptoms between BD-I and BD-NOS. Regardless of BD subtype, current functioning was negatively correlated with decreased need for sleep but not insomnia, and regardless of BD subtype. Conclusion: The majority of youth with BD presents with sleep symptoms during mood episodes. BD NOS presents with the same proportion of sleep symptoms as BD I in our sample.

  6. Is There a Bipolar Prodrome Among Children and Adolescents?

    Science.gov (United States)

    Hunt, Jeffrey; Schwarz, Charlotte M; Nye, Paul; Frazier, Elisabeth

    2016-04-01

    Bipolar disorder in youth substantially impairs behavior, family, and social functioning and interferes with developmental course. There is increasing interest in defining a bipolar prodrome similar to that reported in early-onset psychosis that will allow for earlier intervention and reduction in overall morbidity and mortality. Several lines of research have addressed this important issue including studies of offspring of bipolar parents, high-risk cohorts, and longitudinal follow-up of subjects with major depressive disorder (MDD), ADHD, and bipolar spectrum disorder. The development and validation of bipolar prodrome rating scales also shows promise. Recent attempts to intervene at earlier stages of bipolar disorder have led to some positive outcomes. However, a controversy remains concerning the identification and management of the earliest symptoms. Further research is needed to fully validate a bipolar prodrome and to determine the optimal course of action at various stages of illness.

  7. Driven sexual behavior in bipolar spectrum patients: psychodynamic issues.

    Science.gov (United States)

    Downey, Jennifer I

    2011-01-01

    Recent psychiatric attention to the bipolar spectrum conditions (Bipolar I, Bipolar II, and Bipolar NOS Disorders in the DSM-IV-TR) has revealed that many more individuals are affected by bipolar disorder (BD) than was earlier appreciated. Increased sexual thoughts, impulses, and risk-taking sexual behavior are recognized symptoms of the bipolar conditions when individuals are manic or hypomanic. There is little scientific information on the prevalence of symptoms of driven sexuality in individuals with the less severe forms of BD as well as those individuals with severer forms of the disorder who are recovering or have recovered from an episode of mania or hypomania. This article discusses the use of developmentally oriented psychotherapy for an individual with a bipolar spectrum condition whose symptoms were well controlled on medications except for her driven sexuality. Current concepts in psychodynamic psychotherapy offer a way to understand and treat sexual symptoms in many individuals with less severe or partially treated BD.

  8. PSYCHOPATHOLOGICAL CHARACTERISTICS OF BIPOLAR AND UNIPOLAR DEPRESSION - POTENTIAL INDICATORS OF BIPOLARITY

    OpenAIRE

    Motovsky, Branislav; Pecenak, Jan

    2013-01-01

    Background: Establishing whether a depressive episode is part of a unipolar or bipolar disorder is essential for treatment planning. Over recent years, a growing number of publications have discussed psychopathological characteristics that might serve as indicators of bipolarity in patients with a history of depression dominated by unipolar symptoms. Our primary aim was to verify the adequacy of these indicators in contributing to a precise diagnosis in everyday clinical practice. ...

  9. Kindling and second messengers: an approach to the neurobiology of recurrence in bipolar disorder.

    Science.gov (United States)

    Ghaemi, S N; Boiman, E E; Goodwin, F K

    1999-01-15

    Since bipolar disorder is inherently a longitudinal illness characterized by recurrence and cycling of mood episodes, neurobiological theories involving kindlinglike phenomena appear to possess a certain explanatory power. An approach to understanding kindlinglike phenomena at the molecular level has been made possible by advances in research on second-messenger systems in the brain. The time frame of interest has shifted from the microseconds of presynaptic events to hours, days, months, and even years in the longer duration of events beyond the synapse--through second messengers, gene regulation, and synthesis of long-acting trophic factors. These complex interlocking systems may explain how environmental stress could interact over time with genetic vulnerability to produce illness. In its two sections, this paper will review an approach to understanding two major aspects of the neurobiology of bipolar disorder: kindling phenomena and second-messenger mechanisms. We will suggest that these two fields of research together help explain the biology of recurrence.

  10. Advanced Accelerated Power Cycling Test for Reliability Investigation of Power Device Modules

    DEFF Research Database (Denmark)

    Choi, Uimin; Jørgensen, Søren; Blaabjerg, Frede

    2016-01-01

    This paper presents an apparatus and methodology for an advanced accelerated power cycling test of insulated-gate bipolar transistor (IGBT) modules. In this test, the accelerated power cycling test can be performed under more realistic electrical operating conditions with online wear-out monitori...

  11. Staging systems in bipolar disorder: an International Society for Bipolar Disorders Task Force Report.

    Science.gov (United States)

    Kapczinski, F; Magalhães, P V S; Balanzá-Martinez, V; Dias, V V; Frangou, S; Gama, C S; Gonzalez-Pinto, A; Grande, I; Ha, K; Kauer-Sant'Anna, M; Kunz, M; Kupka, R; Leboyer, M; Lopez-Jaramillo, C; Post, R M; Rybakowski, J K; Scott, J; Strejilevitch, S; Tohen, M; Vazquez, G; Yatham, L; Vieta, E; Berk, M

    2014-11-01

    We discuss the rationale behind staging systems described specifically for bipolar disorders. Current applications, future directions and research gaps in clinical staging models for bipolar disorders are outlined. We reviewed the literature pertaining to bipolar disorders, focusing on the first episode onwards. We systematically searched data on staging models for bipolar disorders and allied studies that could inform the concept of staging. We report on several dimensions that are relevant to staging concepts in bipolar disorder. We consider whether staging offers a refinement to current diagnoses by reviewing clinical studies of treatment and functioning and the potential utility of neurocognitive, neuroimaging and peripheral biomarkers. Most studies to date indicate that globally defined late-stage patients have a worse overall prognosis and poorer response to standard treatment, consistent with patterns for end-stage medical disorders. We believe it is possible at this juncture to speak broadly of 'early'- and 'late'-stage bipolar disorder. Next steps require further collaborative efforts to consider the details of preillness onset and intermediary stages, and how many additional stages are optimal. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. Dealing with bipolar disorder in general practice

    African Journals Online (AJOL)

    Review Article: Dealing with bipolar disorder in general practice. 551. Vol 53 No 6. S Afr Fam Pract 2011 antisocial personality disorder, alcohol or substance misuse or dependence, and schizoaffective disorder.2. The diagnosis is frequently difficult to make, and may not be obvious, even to the most practised eye. In order ...

  13. Social dysfunction in bipolar disorder: pilot study.

    Science.gov (United States)

    de Almeida Rocca, Cristiana Castanho; de Macedo-Soares, Marcia Britto; Gorenstein, Clarice; Tamada, Renata Sayuri; Issler, Cilly Kluger; Dias, Rodrigo Silva; Schwartzmann, Angela Maria; Lafer, Beny

    2008-08-01

    The purpose of the present study was to assess the social skills of euthymic patients with bipolar disorder. A group of 25 outpatients with bipolar disorder type I were evaluated in comparison with a group of 31 healthy volunteers who were matched in terms of level of education, age, sex and intelligence. Both groups were assessed using a self-report questionnaire, the Brazilian Inventario de Habilidades Sociais (IHS, Social Skills Inventory). Two Wechsler Adult Intelligence Scale subtests (Picture Arrangement and Comprehension) were also used in order to assess subject ability to analyse social situations and to make judgements, respectively. Patients with bipolar disorder had lower IHS scores for the domains that assessed conversational skills/social self-confidence and social openness to new people/situations. Patients with anxiety disorders had high scores for the domain that assessed self-confidence in the expression of positive emotions. No differences were found between patients and controls in performance on the Wechsler Adult Intelligence Scale Picture Arrangement and Comprehension subtests. Euthymic patients with bipolar disorder present inhibited and overattentive behaviour in relation to other people and their environment. This behaviour might have a negative impact on their level of social functioning and quality of life.

  14. Oxide bipolar electronics: materials, devices and circuits

    Science.gov (United States)

    Grundmann, Marius; Klüpfel, Fabian; Karsthof, Robert; Schlupp, Peter; Schein, Friedrich-Leonhard; Splith, Daniel; Yang, Chang; Bitter, Sofie; von Wenckstern, Holger

    2016-06-01

    We present the history of, and the latest progress in, the field of bipolar oxide thin film devices. As such we consider primarily pn-junctions in which at least one of the materials is a metal oxide semiconductor. A wide range of n-type and p-type oxides has been explored for the formation of such bipolar diodes. Since most oxide semiconductors are unipolar, challenges and opportunities exist with regard to the formation of heterojunction diodes and band lineups. Recently, various approaches have led to devices with high rectification, namely p-type ZnCo2O4 and NiO on n-type ZnO and amorphous zinc-tin-oxide. Subsequent bipolar devices and applications such as photodetectors, solar cells, junction field-effect transistors and integrated circuits like inverters and ring oscillators are discussed. The tremendous progress shows that bipolar oxide electronics has evolved from the exploration of various materials and heterostructures to the demonstration of functioning integrated circuits. Therefore a viable, facile and high performance technology is ready for further exploitation and performance optimization.

  15. Cognitive enhancement treatments for bipolar disorder

    DEFF Research Database (Denmark)

    Miskowiak, Kamilla W; Carvalho, André F; Vieta, Eduard

    2016-01-01

    Cognitive dysfunction is an emerging treatment target in bipolar disorder (BD). Several trials have assessed the efficacy of novel pharmacological and psychological treatments on cognition in BD but the findings are contradictory and unclear. A systematic search following the PRISMA guidelines...

  16. Novel antipsychotics in bipolar and schizoaffective mania

    NARCIS (Netherlands)

    Slooff, CJ

    Objective: Novel antipsychotics are increasingly used in the treatment of bipolar and schizoaffective mania. This paper presents an overview of the controlled studies in this field. Method: Using cross-references, a computerized search was performed on MEDLINE and EMBASE psychiatry covering the

  17. Comorbidity of bipolar disorder and eating disorders.

    Science.gov (United States)

    Álvarez Ruiz, Eva M; Gutiérrez-Rojas, Luis

    2015-01-01

    The comorbidity of bipolar disorder and eating disorders has not been studied in depth. In addition, clinical implications involved in the appearance of both disorders are very important. A systematic literature review of MEDLINE published up to September 2013 was performed, analyzing all the articles that studied the comorbidity of both conditions (bipolar disorder and eating disorders) and others research that studied the efficacy of pharmacological treatment and psychotherapy to improve these illnesses. In this review we found a high comorbidity of bipolar disorder and eating disorders, especially of bulimia nervosa and binge eating disorder. Studies show that lithium and topiramate are 2 of the more effective pharmacological agents in the treatment of both disorders. There are a lot of studies that show evidence of comorbidity of bipolar disorder and eating disorders. However, further research is needed on assessment and treatment when these conditions co-exist, as well as study into the biopsychological aspects to determine the comorbid aetiology. Copyright © 2014 SEP y SEPB. Published by Elsevier España. All rights reserved.

  18. Matricídio e transtorno bipolar

    National Research Council Canada - National Science Library

    Valença, Alexandre Martins; Mezzasalma, Marco André; Nascimento, Isabella; Nardi, Antonio Egidio

    2009-01-01

    .... Estudos de casos de matricídio têm revelado a presença de transtornos mentais, tais como esquizofrenia, transtorno bipolar, transtornos de personalidade e alcoolismo, assim como casos em que não há...

  19. Self-oscillating inverter with bipolar transistors

    Science.gov (United States)

    Baciu, I.; Cunţan, C. D.; Floruţa, M.

    2016-02-01

    The paper presents a self-oscillating inverter manufactured with bipolar transistors that supplies a high-amplitude alternating voltage to a fluorescent tube with a burned filament. The inverter is supplied from a low voltage accumulator that can be charged from a photovoltaic panel through a voltage regulator.

  20. Brazed bipolar plates for PEM fuel cells

    Science.gov (United States)

    Neutzler, Jay Kevin

    1998-01-01

    A liquid-cooled, bipolar plate separating adjacent cells of a PEM fuel cell comprising corrosion-resistant metal sheets brazed together so as to provide a passage between the sheets through which a dielectric coolant flows. The brazement comprises a metal which is substantially insoluble in the coolant.

  1. Bipolarity and Ambivalence in Landscape Architecture

    NARCIS (Netherlands)

    Koh, J.

    2010-01-01

    Our discipline of landscape architecture contains bipolarity, not only in terms of landscape and architecture but also because the idea of landscape is both aesthetic and scientific. Furthermore, within landscape architecture there is a gap between design (as implied by architecture) and planning

  2. Bias in emerging biomarkers for bipolar disorder

    DEFF Research Database (Denmark)

    Carvalho, A F; Köhler, C A; Fernandes, B S

    2016-01-01

    BACKGROUND: To date no comprehensive evaluation has appraised the likelihood of bias or the strength of the evidence of peripheral biomarkers for bipolar disorder (BD). Here we performed an umbrella review of meta-analyses of peripheral non-genetic biomarkers for BD. METHOD: The Pubmed/Medline, E...

  3. Cognition and functioning in bipolar depression

    Directory of Open Access Journals (Sweden)

    Natalia S. Kapczinski

    2016-01-01

    Full Text Available Objectives: Depressive symptoms are associated with worse outcomes in patients with bipolar disorder (BD. However, scarce data are available regarding neurocognitive profiles across different areas of functioning among BD patients with moderate and severe depression. Our objective was to assess cognition and global functioning in a group of patients with bipolar depression. Methods: Data were available for 100 patients with bipolar depression (78% female and 70 controls (64% female paired by age and education level. Cognitive function was assessed with a neuropsychological test battery. Functioning was assessed with the Functioning Assessment Short Test. Results: In patients, severe depression was associated with poorer cognitive performance on measures of executive function. Patients with severe depression showed worse global functioning than those with moderate depression (z = 2.54, p = 0.011. In patients with severe depression, lower global functioning was associated with lower scores in working memory (r = -0.200, p = 0.010, and executive function (r = -0.210, p = 0.007; and r = 0.293, p < 0.001. Conclusion: Our findings suggest cognitive impairment and global functioning impairment are associated with the severity of depressive symptoms in bipolar depression. Intensive treatment of depressive symptoms in patients with BD is crucial to improve cognitive functioning and, consequently, functional outcomes.

  4. Gravitomagnetic Separation of Bipolar Charged Martian Dust

    Science.gov (United States)

    Arias, FJ

    2017-09-01

    In this work it is shown that magnetic anomalies on Mars can actually boost gravitational spatial separation of bipolar charged Martian dust. If so, these places are prone for high electrical activity and then formation of chemical process requiring electrical sparks.

  5. Unraveling Psychomotor Slowing in Bipolar Disorde

    NARCIS (Netherlands)

    Morsel, A.M.; Temmerman, A.; Sabbe, B.G.C.; Hulstijn, W.; Morrens, M.

    2015-01-01

    Background/Aims: In addition to affective and cognitive symptomatology, psychomotor deficits are known to be present in bipolar disorder (BD). Psychomotor functioning includes all of the processes necessary for completing a movement, from planning to initiation and execution. While these psychomotor

  6. Unblending Borderline Personality and Bipolar Disorders.

    Science.gov (United States)

    di Giacomo, Ester; Aspesi, Flora; Fotiadou, Maria; Arntz, Arnoud; Aguglia, Eugenio; Barone, Lavinia; Bellino, Silvio; Carpiniello, Bernardo; Colmegna, Fabrizia; Lazzari, Marina; Lorettu, Liliana; Pinna, Federica; Sicaro, Aldo; Signorelli, Maria Salvina; Clerici, Massimo

    2017-08-01

    Borderline Personality (BPD) and Bipolar (BP) disorders stimulate an academic debate between their distinction and the inclusion of Borderline in the Bipolar spectrum. Opponents to this inclusion attribute the important differences and possible diagnostic incomprehension to overlapping symptoms. We tested 248 Borderline and 113 Bipolar patients, consecutively admitted to the Psychiatric Unit, through DSM-IV Axis I and II Disorders (SCID-I/II), Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A), Young Mania Rating Scale (YMRS) and Borderline Personality Disorder Severity Index-IV (BPDSI-IV). All the tests statistically discriminated the disorders (p disorders to a higher degree. Comorbidity proves to be extremely small (3.6%). However, Borderline patients with manic features offer a privileged point of view for a deeper analysis. This allows for the possibility of a more precise examination of the nature and load of each symptom. Borderline Personality and Bipolar Disorders can be distinguished with high precision using common and time-sparing tests. The importance of discriminating these clinical features may benefit from this evidence. Copyright © 2017. Published by Elsevier Ltd.

  7. Emotion regulation deficits in euthymic bipolar I versus bipolar II disorder: a functional and diffusion-tensor imaging study

    Science.gov (United States)

    Caseras, Xavier; Murphy, Kevin; Lawrence, Natalia S; Fuentes-Claramonte, Paola; Watts, Jessica; Jones, Derek K; Phillips, Mary L

    2015-01-01

    Objectives Emotion regulation deficits are a core feature of bipolar disorder. However, their potential neurobiological underpinnings and existence beyond bipolar I disorder remain unexplored. Our main goal was to investigate whether both individuals with bipolar I and bipolar II disorder show deficits in emotion regulation during an attention control task, and to explore the neurophysiological underpinnings of this potential deficit. Methods Twenty healthy controls, 16 euthymic participants with bipolar I disorder, and 19 euthymic participants with bipolar II disorder completed psychometric and clinical assessments, a neuroimaging emotion regulation paradigm, and an anatomical diffusion-weighted scan. Groups were matched for age, gender, and verbal IQ. Results During the presence of emotional distracters, subjects with bipolar I disorder showed slowed reaction times to targets, and increased blood oxygenation level-dependent (BOLD) responses in the amygdala, accumbens, and dorsolateral prefrontal cortex, but not increased inverse functional connectivity between these prefrontal and subcortical areas, and altered white matter microstructure organization in the right uncinate fasciculus. Subjects with bipolar II disorder showed no altered reaction times, increased BOLD responses in the same brain areas, increased inverse functional connectivity between the prefrontal cortex and amygdala, and no abnormalities in white matter organization. Conclusions Participants with bipolar I disorder showed abnormalities in functional and anatomical connectivity between prefrontal cortices and subcortical structures in emotion regulation circuitry. However, these deficits did not extend to subjects with bipolar II disorder, suggesting fundamental differences in the pathophysiology of bipolar disorder subtypes. PMID:25771686

  8. Activation in Bipolar Disorders: A Systematic Review.

    Science.gov (United States)

    Scott, Jan; Murray, Greg; Henry, Chantal; Morken, Gunnar; Scott, Elizabeth; Angst, Jules; Merikangas, Kathleen R; Hickie, Ian B

    2017-02-01

    Increased activity and energy alongside mood change are identified in the DSM-5 as cardinal symptoms of mania and hypomania. A wide range of existing research suggests that this revision may be valid, but systematic integration of the evidence has not been reported. The term activation is understood as emerging from underlying physiological change and having objective (observable motor activity) and related subjective (energy) levels. To systematically review studies of the clinical phenomenon of activation in bipolar disorder, to determine whether activation is statistically abnormal in bipolar disorder and demonstrably distinct from mood, and to identify any significant between- and within-individual differences in the dynamics of activation. This systematic review of MEDLINE, PsycINFO, EMBASE, CINAHL, and PubMed databases from January 1, 1970, until September 30, 2016, identified 56 of a possible 3284 citations for (1) data-driven analyses of the dimensions and factor structure of mania and bipolar depression and (2) longitudinal studies reporting real-time objective monitoring or momentary assessment of daytime activity in individuals with bipolar disorder compared with other clinical or healthy control samples. Hand search of reference lists, specialty journals, websites, published conference proceedings, and dissertation abstracts and contact with other researchers ensured inclusion of gray literature and additional analyses as well as raw data if appropriate. Quality assessment was perfomed using the National Institutes of Health quality assessment tool. A total of 56 studies met eligibility criteria for inclusion in the review including 29 analyses of the factor structure of bipolar disorder, 3 of activity data from experimental sampling or ecological momentary assessment, and 20 actigraphy and 4 laboratory-based studies. Synthesizing findings across the studies revealed that the most robust finding was that mean levels of activity are lower during euthymia

  9. The developmental trajectory of bipolar disorder.

    Science.gov (United States)

    Duffy, Anne; Horrocks, Julie; Doucette, Sarah; Keown-Stoneman, Charles; McCloskey, Shannon; Grof, Paul

    2014-02-01

    Bipolar disorder is highly heritable and therefore longitudinal observation of children of affected parents is important to mapping the early natural history. To model the developmental trajectory of bipolar disorder based on the latest findings from an ongoing prospective study of the offspring of parents with well-characterised bipolar disorder. A total of 229 offspring from families in which 1 parent had confirmed bipolar disorder and 86 control offspring were prospectively studied for up to 16 years. High-risk offspring were divided into subgroups based on the parental long-term response to lithium. Offspring were clinically assessed and DSM-IV diagnoses determined on masked consensus review using best estimate procedure. Adjusted survival analysis and generalised estimating equations were used to calculate differences in lifetime psychopathology. Multistate models were used to examine the progression through proposed clinical stages. High-risk offspring had an increased lifetime risk of a broad spectrum of disorders including bipolar disorder (hazard ratio (HR) = 20.89; P = 0.04), major depressive disorder (HR = 17.16; P = 0.004), anxiety (HR = 2.20; P = 0.03), sleep (HR = 28.21; P = 0.02) and substance use disorders (HR = 2.60; P = 0.05) compared with controls. However, only offspring from lithium non-responsive parents developed psychotic disorders. Childhood anxiety disorder predicted an increased risk of major mood disorder and evidence supported a progressive transition through clinical stages, from non-specific psychopathology to depressive and then manic or psychotic episodes. Findings underscore the importance of a developmental approach in conjunction with an appreciation of familial risk to facilitate earlier accurate diagnosis in symptomatic youth.

  10. Unmet needs of bipolar disorder patients

    Directory of Open Access Journals (Sweden)

    Hajda M

    2016-06-01

    Full Text Available Miroslav Hajda,1 Jan Prasko,1 Klara Latalova,1 Radovan Hruby,2 Marie Ociskova,1 Michaela Holubova,1,3 Dana Kamaradova,1 Barbora Mainerova1 1Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc, Czech Republic; 2Outpatient Psychiatric Department, Martin, Slovak Republic; 3Department of Psychiatry, Regional Hospital Liberec, Liberec, Czech Republic Background: Bipolar disorder (BD is a serious mental illness with adverse impact on the lives of the patients and their caregivers. BD is associated with many limitations in personal and interpersonal functioning and restricts the patients’ ability to use their potential capabilities fully. Bipolar patients long to live meaningful lives, but this goal is hard to achieve for those with poor insight. With progress and humanization of society, the issue of patients’ needs became an important topic. The objective of the paper is to provide the up-to-date data on the unmet needs of BD patients and their caregivers. Methods: A systematic computerized examination of MEDLINE publications from 1970 to 2015, via the keywords “bipolar disorder”, “mania”, “bipolar depression”, and “unmet needs”, was performed. Results: Patients’ needs may differ in various stages of the disorder and may have different origin and goals. Thus, we divided them into five groups relating to their nature: those connected with symptoms, treatment, quality of life, family, and pharmacotherapy. We suggested several implications of these needs for pharmacotherapy and psychotherapy. Conclusion: Trying to follow patients’ needs may be a crucial point in the treatment of BD patients. However, many needs remain unmet due to both medical and social factors. Keywords: bipolar disorder, unmet needs, stigma, treatment, medication, quality of life, family, psychotherapy

  11. The relationship between borderline personality disorder and bipolar disorder

    Science.gov (United States)

    Zimmerman, Mark; Morgan, Theresa A.

    2013-01-01

    It is clinically important to recognize both bipolar disorder and borderline personality disorder (BPD) in patients seeking treatment for depression, and it is important to distinguish between the two. Research considering whether BPD should be considered part of a bipolar spectrum reaches differing conclusions. We reviewed the most studied question on the relationship between BPD and bipolar disorder: their diagnostic concordance. Across studies, approximately 10% of patients with BPD had bipolar I disorder and another 10% had bipolar II disorder. Likewise, approximately 20% of bipolar II patients were diagnosed with BPD, though only 10% of bipolar I patients were diagnosed with BPD. While the comorbidity rates are substantial, each disorder is nontheless diagnosed in the absence of the other in the vast majority of cases (80% to 90%). In studies examining personality disorders broadly, other personality disorders were more commonly diagnosed in bipolar patients than was BPD. Likewise, the converse is also true: other axis I disorders such as major depression, substance abuse, and post-traumatic stress disorder are also more commonly diagnosed in patients with BPD than is bipolar disorder. These findings challenge the notion that BPD is part of the bipolar spectrum. PMID:24174890

  12. Sleep study in Disruptive Mood Dysregulation Disorder and Bipolar children.

    Science.gov (United States)

    Estrada-Prat, Xavier; Álvarez-Guerrico, Ion; Bleda-Hernández, María J; Camprodon-Rosanas, Ester; Batlle-Vila, Santiago; Pujals-Altes, Elena; Nascimento-Osorio, María T; Martín-López, Luís M; Álvarez-Martínez, Enric; Pérez-Solá, Víctor; Romero-Cela, Soledad

    2017-01-01

    Decreased need for sleep has been proposed as a core symptom of mania and it has been associated with the pathogenesis of Bipolar Disorder. The emergence of Disruptive Mood Dysregulation Disorder (DMDD) as a new diagnostic has been controversial and much has been speculated about its relationship with the bipolar spectrum. REM sleep fragmentation could be a biomarker of affective disorders and it would help us to differentiate them from other disorders. Polysomnographic cross-sectional study of children with DMDD, bipolar disorder and Attention Deficit Hyperactivity Disorder (ADHD). All participants underwent a psychiatric semi-structured interview to obtain the diagnosis, comorbidities and primary sleep disorders. DMDD’s sample was performed following DSM5 criteria. Perform polysomnography in a sample of bipolar, DMDD and ADHD children and compare their profiles to provide more evidence about the differences or similarities between bipolar disorder and DMDD. Bipolar group had the highest REM density values while ADHD had the lowest. REM density was not statiscally different between bipolar phenotypes. REM density was associated with antidepressant treatment, episodes of REM and their interaction. REM latency was associated with antipsychotic treatment and school performance. Bipolar patients had higher scores on the depression scale than DMDD and ADHD groups. No significant differences between the two compared affective disorders were found. However there were differences in REM density between bipolar and ADHD groups. REM sleep study could provide a new theoretical framework to better understand the pathogenesis of pediatric bipolar disorder.

  13. Systematic review of the prevalence of bipolar disorder and bipolar spectrum disorders in population-based studies

    Directory of Open Access Journals (Sweden)

    José Caetano Dell'Aglio Jr.

    2013-01-01

    Full Text Available This paper describes the findings of a systematic literature review aimed at providing an overview of the lifetime prevalence of bipolar disorder and bipolar spectrum disorders in population-based studies. Databases MEDLINE, ProQuest, Psychnet, and Web of Science were browsed for papers published in English between 1999 and May 2012 using the following search string: bipolar disorders OR bipolar spectrum disorders AND prevalence OR cross-sectional OR epidemiology AND population-based OR non-clinical OR community based. The search yielded a total of 434 papers, but only those published in peer-reviewed journals and with samples aged ≥ 18 years were included, resulting in a final sample of 18 papers. Results revealed rather heterogeneous findings concerning the prevalence of bipolar disorders and bipolar spectrum disorders. Lifetime prevalence of bipolar disorder ranged from 0.1 to 7.5%, whereas lifetime prevalence of bipolar spectrum disorders ranged from 2.4 to 15.1%. Differences in the rates of bipolar disorder and bipolar spectrum disorders may be related to the consideration of subthreshold criteria upon diagnosis. Differences in the prevalence of different subtypes of the disorder are discussed in light of diagnostic criteria and instruments applied.

  14. Thwarted interpersonal needs and suicide ideation: Comparing psychiatric inpatients with bipolar and non-bipolar mood disorders.

    Science.gov (United States)

    Taylor, Nathanael J; Mitchell, Sean M; Roush, Jared F; Brown, Sarah L; Jahn, Danielle R; Cukrowicz, Kelly C

    2016-12-30

    Psychiatric inpatients are at heightened risk for suicide, and evidence suggests that psychiatric inpatients with bipolar mood disorders may be at greater risk for suicide ideation compared to those with non-bipolar mood disorders. There is a paucity of research directly comparing risk factors for suicide ideation in bipolar versus non-bipolar mood disorders in an inpatient sample. The current study sought to clarify the association between two constructs from the interpersonal theory of suicide (i.e., perceived burdensomeness and thwarted belongingness) in leading to suicide ideation among psychiatric inpatients with bipolar and non-bipolar mood disorders. Participants were (N=90) psychiatric inpatients with a bipolar (n = 20) or non-bipolar mood disorder (n=70; per their medical charts). Perceived burdensomeness, but not thwarted belongingness, was significantly associated with suicide ideation after adjusting for other covariates. This suggests perceived burdensomeness may play a key role in suicide ideation among psychiatric inpatients with any mood disorder and highlights the importance of assessment and intervention of perceived burdensomeness in this population. Contrary to our hypothesis, mood disorder group (i.e., bipolar versus non-bipolar) did not moderate the relations between perceived burdensomeness/thwarted belongingness and suicide ideation. Published by Elsevier Ireland Ltd.

  15. Abordagens psicoterápicas no transtorno bipolar Psychoterapeutic approach in bipolar disorder

    Directory of Open Access Journals (Sweden)

    Paulo Knapp

    2005-01-01

    Full Text Available Embora o tratamento farmacológico seja essencial para o tratamento do transtorno bipolar, apenas 40% de todos os pacientes que aderem às medicações permanecem assintomáticos durante o período de seguimento, o que tem levado ao desenvolvimento de intervenções psicoterápicas associadas. O objetivo deste artigo é examinar as evidências atuais da eficácia de intervenções psicoterápicas no tratamento do transtorno bipolar. Foi realizada uma pesquisa bibliográfica por meio do MedLine, PsychoINFO, Lilacs e Cochrane Data Bank, até o ano de 2004, em que foram procurados artigos originais e revisões sobre as abordagens psicoterápicas utilizadas no tratamento do transtorno bipolar. Há várias abordagens que podem se mostrar úteis no tratamento do transtorno bipolar. A psicoeducação e a terapia cognitivo-comportamental apresentam as evidências mais consistentes e são as técnicas mais amplamente estudadas. As intervenções envolvendo familiares e a terapia interpessoal e de ritmo social se mostram tratamentos eficazes em determinadas situações. Há alguns estudos empregando a terapia psicodinâmica no transtorno bipolar, mas são estudos com limitações metodológicas. Apesar de haver evidências demonstrando a eficácia de determinadas abordagens psicoterápicas no transtorno bipolar, ainda é necessária a realização de estudos posteriores que comprovem tais dados e que desenvolvam tratamentos baseados em modelos etiológicos e que identifiquem tratamentos específicos para as diferentes fases e tipos de transtorno bipolar.Although pharmacological treatment is essential for treating bipolar disorder, less than half of all medication compliant patients are non-symptomatic during follow-up, which has led to developments of adjunctive psychosocial interventions. This paper examines the current evidence for effectiveness of psychotherapeutic interventions in the treatment of bipolar disorder. Searches were undertaken through Med

  16. Storm in My Brain: Kids and Mood Disorders (Bipolar Disorder and Depression)

    Science.gov (United States)

    ... Brain Kids and Mood Disorders (Bipolar Disorder and Depression) What is a mood disorder? Everyone feels sad, ... one part of bipolar disorder, also called manic depression. In bipolar disorder, moods change between mania (excited ...

  17. Bipolar disorder dynamics: affective instabilities, relaxation oscillations and noise

    Science.gov (United States)

    Geddes, John R.; Goodwin, Guy M.; Holmes, Emily A.

    2015-01-01

    Bipolar disorder is a chronic, recurrent mental illness characterized by extreme episodes of depressed and manic mood, interspersed with less severe but highly variable mood fluctuations. Here, we develop a novel mathematical approach for exploring the dynamics of bipolar disorder. We investigate how the dynamics of subjective experience of mood in bipolar disorder can be understood using a relaxation oscillator (RO) framework and test the model against mood time-series fluctuations from a set of individuals with bipolar disorder. We show that variable mood fluctuations in individuals diagnosed with bipolar disorder can be driven by the coupled effects of deterministic dynamics (captured by ROs) and noise. Using a statistical likelihood-based approach, we show that, in general, mood dynamics are described by two independent ROs with differing levels of endogenous variability among individuals. We suggest that this sort of nonlinear approach to bipolar disorder has neurobiological, cognitive and clinical implications for understanding this mental illness through a mechacognitive framework. PMID:26577592

  18. Studies of offspring of parents with bipolar disorder.

    Science.gov (United States)

    Chang, Kiki; Steiner, Hans; Ketter, Terence

    2003-11-15

    Children and adolescents who are the biological offspring of individuals with bipolar disorder (BD) (bipolar offspring) represent a population rich in potential for revealing important aspects in the development of BD. Multiple cross-sectional assessments of psychopathology in bipolar offspring have confirmed high incidences of BD, as well as mood and behavioral disorders, and other psychopathology in this population. Longitudinal studies of offspring have begun to shed light on precursors of BD development. Other assessments of bipolar offspring have included dimensional reports of psychiatric and psychosocial functioning, temperament assessments, and descriptions of family environments and parenting styles. Neurobiological studies in bipolar offspring are just beginning to yield findings that may be related to the underlying neuropathophysiology of BD. The future holds promise for longitudinal studies of bipolar offspring incorporating all of these facets, including genetic analyses, to further elucidate the factors involved in the evolution of BD. Copyright 2003 Wiley-Liss, Inc.

  19. [Bipolar disorder and psychoanalytical concepts of depression and mania].

    Science.gov (United States)

    Solimano, Alberto; Manfredi, Clelia

    2006-01-01

    The categorical diagnostic model of bipolar disorders (DSM IV) has brought about increasing questioning, since its use gains troubles related not only to clinical experience, but to epidemiological studies as well. Regarding this, other models have emerged, such as the bipolar spectrum by Akiskal that covers the classic bipolar disorder on one side to unipolar disorder on the other, including soft bipolar disorders as well. The authors start from this notion of bipolar spectrum to set out the relationship between bipolar disease and psychoanalytical concepts of depression and mania. They develop Freud's basic theories and those of the British School that constitute a strong and coherent theoretical structure. Psychoanalysis proposes a unitary psychopathological model that manifests itself as depression or maniac reaction as secondary defense, to account for both the clinical expression and the psychodynamic comprehension of mood disorders.

  20. Effects of acute aerobic exercise on neural correlates of attention and inhibition in adolescents with bipolar disorder

    OpenAIRE

    Metcalfe, A W S; MacIntosh, B.J.; Scavone, A; Ou, X; Korczak, D; Goldstein, B I

    2016-01-01

    Executive dysfunction is common during and between mood episodes in bipolar disorder (BD), causing social and functional impairment. This study investigated the effect of acute exercise on adolescents with BD and healthy control subjects (HC) to test for positive or negative consequences on neural response during an executive task. Fifty adolescents (mean age 16.54?1.47 years, 56% female, 30 with BD) completed an attention and response inhibition task before and after 20?min of recumbent cycl...

  1. Revisiting depressive-prone bipolar disorder: polarity of initial mood episode and disease course among bipolar I systematic treatment enhancement program for bipolar disorder participants.

    Science.gov (United States)

    Perlis, Roy H; Delbello, Melissa P; Miyahara, Sachiko; Wisniewski, Stephen R; Sachs, Gary S; Nierenberg, Andrew A

    2005-10-01

    We examined the hypothesis that a first depressive rather than manic episode in bipolar disorder might herald a subsequent course notable for greater burden of depressive symptoms. We analyzed retrospective data on the polarity of first mood episode obtained from 704 bipolar I subjects entering the multicenter Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) study. Subjects with an initial manic or depressive episode and those in whom both poles occurred within the same year were compared. Depressive-onset bipolar disorder was more common in women and those with earlier onset of illness. Adjusting for these differences, it was significantly associated with more lifetime depressive episodes and a greater proportion of time with depression and anxiety in the year prior to study entry. Polarity of first mood episode may be useful in distinguishing subsets of bipolar patients at risk for a more chronic course.

  2. The bipolar II disorder personality traits, a true syndrome?

    Science.gov (United States)

    Gudmundsson, Einar

    2015-06-01

    The author was struck by the similarities and commonality of complaints, aside from mood swings, made by Bipolar II patients and started registrating these complaints. This registrational work eventually led to the development of The Bipolar II Syndome Checklist. The aim of this work was to understand how widely the Bipolar II disorder affects the personality, and what disturbing personality traits are the most common? Deliberately, no attempt was made to diagnose psychiatric comorbidities, in the hope that one would get a clearer view of what symptoms, if any, could be considered a natural part of the Bipolar II Disorder. As far as the author knows this is a novel approach. 105 Bipolar II patients completed the Bipolar II Syndrome Checklist. The answers to the 44 questions on the list are presented in tables. Symptoms like anxiety, low self esteem, paranoia, extreme hurtfulness, migraine, Post Partum Depression, obsessive traits, alcoholism in the family are amongst the findings which will be presented in greater detail. No control group. Bipolar I patients excluded. The Bipolar II Syndrome Checklist has not been systematically validated. The results show that Bipolar II Disorder causes multiple symptoms so commonly that it may be justified to describe it as a syndrome, The Bipolar II Syndrome. Also these disturbances commonly lie in families of Bipolar II patients and are in all likelihood, greatly underdiagnosed. The clinical relevance of this study lies in increasing our knowledge and understanding of the nature of the Bipolar II Disorder, which in all probability will increase the diagnostic and treatment accuracy, since clinicians are more likely to scan for other symptoms needing treatment. Copyright © 2015 Elsevier B.V. All rights reserved.

  3. Current research in child and adolescent bipolar disorder

    OpenAIRE

    Demeter, Christine A.; Townsend, Lisa D.; Wilson, Michael; Findling, Robert L.

    2008-01-01

    Although recently more research has considered children with bipolar disorder than in the past, much controversy still surrounds the validity of the diagnosis. Furthermore, questions remain as to whether or not childhood expressions of bipolarity are continuous with adult manifestations of the illness. In order to advance current knowledge of bipolar disorders in children, researchers have begun to conduct phenomenological, longitudinal, treatment, and neuroimaging studies in youths who exhib...

  4. Late-Onset Bipolar Disorder: A Case Report.

    Science.gov (United States)

    Farahmand, Pantea; Sinha, Shirshendu; Patel, Sagar; Zdanys, Kristina

    2015-05-01

    Treating refractory late-onset bipolar disorder has not been sufficiently presented in the literature. In this case report, we present a 54-year-old male with late-onset bipolar disorder, who did notimprove despite multiple medication and dosage changes. This case outlines the challenges in treatment of these patients as well as identifies areas of further study regarding late-onset bipolar disorder management.

  5. Perturbed reward processing in pediatric bipolar disorder: an antisaccade study

    OpenAIRE

    Mueller, Sven C.; Ng, Pamela; Temple, Veronica; Hardin, Michael G.; Pine, Daniel S.; Leibenluft, Ellen; Ernst, Monique

    2010-01-01

    Pediatric bipolar disorder is a severe and impairing illness. Characterizing the impact of pediatric bipolar disorder on cognitive function might aid in understanding the phenomenology of the disorder. While previous studies of pediatric bipolar disorder have reported deficits in cognitive control and reward behavior, little is understood about how affective processes influence behavioral control. Relative to prior studies using manual-response paradigms, eye movement tasks provide a more pre...

  6. Differential diagnosis of bipolar disorder and major depressive disorder.

    Science.gov (United States)

    Hirschfeld, R M

    2014-12-01

    Patients with bipolar disorder spend approximately half of their lives symptomatic and the majority of that time suffering from symptoms of depression, which complicates the accurate diagnosis of bipolar disorder. Challenges in the differential diagnosis of bipolar disorder and major depressive disorder are reviewed, and the clinical utility of several screening instruments is evaluated. The estimated lifetime prevalence of major depressive disorder (i.e., unipolar depression) is over 3 and one-half times that of bipolar spectrum disorders. The clinical presentation of a major depressive episode in a bipolar disorder patient does not differ substantially from that of a patient with major depressive disorder (unipolar depression). Therefore, it is not surprising that without proper screening and comprehensive evaluation many patients with bipolar disorder may be misdiagnosed with major depressive disorder (unipolar depression). In general, antidepressants have demonstrated little or no efficacy for depressive episodes associated with bipolar disorder, and treatment guidelines recommend using antidepressants only as an adjunct to mood stabilizers for patients with bipolar disorder. Thus, correct identification of bipolar disorder among patients who present with depression is critical for providing appropriate treatment and improving patient outcomes. Clinical characteristics indicative of bipolar disorder versus major depressive disorder identified in this review are based on group differences and may not apply to each individual patient. The overview of demographic and clinical characteristics provided by this review may help medical professionals distinguish between major depressive disorder and bipolar disorder. Several validated, easily administered screening instruments are available and can greatly improve the recognition of bipolar disorder in patients with depression. Copyright © 2014 Elsevier B.V. All rights reserved.

  7. Ziprasidone monotherapy in pediatric bipolar disorder.

    Science.gov (United States)

    Barnett, Michael S

    2004-01-01

    Four children, aged 7-16 years, with bipolar disorder were switched to ziprasidone from mood stabilizers, anticonvulsants, or other atypical antipsychotics because of poor response, troubling side effects, breakthrough symptoms, or concern over potential toxicity. Within 3 days, patients experienced a resolution of hypomania, hallucinations, aggression, irritability, depression, and insomnia. One 16-year-old, who was switched from carbamazapine, also required adjunctive lorazepam for situational anxiety; the others either responded to, or were ultimately managed with, ziprasidone monotherapy. Side effects were mostly mild and transitory. Patients experiencing sedation or wakefulness at dose escalation were maintained at the previous 20- or 40-mg dose level until side effects resolved. Ziprasidone's efficacy, fast onset of action, and good safety profile warrant a more systematic study of this agent in pediatric patients with bipolar disorder.

  8. Bipolar zinc/oxygen battery development

    Energy Technology Data Exchange (ETDEWEB)

    Mueller, S. [Paul Scherrer Inst. (PSI), Villigen (Switzerland); Schlatter, C. [Swiss Federal Inst. of Technology, Lausanne (Switzerland)

    1997-06-01

    A bipolar electrically rechargeable Zn/O{sub 2} battery has been developed. Reticulated copper foam served as substrate for the zinc deposit on the anodic side, and La{sub 0.6}Ca{sub 0.4}CoO{sub 3}-catalyzed bifunctional oxygen electrodes were used on the cathodic side of the cells. The 100 cm{sup 2} unit cell had an open circuit voltage of 1,4 V(O{sub 2}) in moderately alkaline electrolyte. The open circuit voltage and the peak power measured for a stack containing seven cells were ca. 10V and 90W, respectively. The current-potential behaviour was determined as a function of the number of bipolar cells, and the maximum discharge capacity was determined at different discharge rates. (author) 4 figs., 1 ref.

  9. Udvikling af medicinsk behandling mod bipolar lidelse

    DEFF Research Database (Denmark)

    Ellegaard, Pernille Kempel

    2015-01-01

    Selvom Esbjerg ligger i vandkants Danmark, er det den Psykiatriske Forskningsenhed i denne by, der er primus motor for et stort forsøg blandt mennesker, der lider af bipolar lidelse. Forsøget hedder ”NACOS”, og er et medicinsk forsøg til mennesker, der befinder sig i den depressive fase.......Selvom Esbjerg ligger i vandkants Danmark, er det den Psykiatriske Forskningsenhed i denne by, der er primus motor for et stort forsøg blandt mennesker, der lider af bipolar lidelse. Forsøget hedder ”NACOS”, og er et medicinsk forsøg til mennesker, der befinder sig i den depressive fase....

  10. Diagnostic stability in pediatric bipolar disorder

    DEFF Research Database (Denmark)

    Vedel Kessing, Lars; Vradi, Eleni; Andersen, Per Kragh

    2015-01-01

    BACKGROUND: The diagnostic stability of pediatric bipolar disorder has not been investigated previously. The aim was to investigate the diagnostic stability of the ICD-10 diagnosis of pediatric mania/bipolar disorder.METHODS: All patients below 19 years of age who got a diagnosis of mania...... disorder (14.8%) and behavioral and emotional disorders with onset during childhood or adolescents (10.9%). Prevalence rates of schizophrenia, personality disorders, anxiety disorder or hyperkinetic disorders (ADHD) were low.LIMITATIONS: Data concern patients who get contact to hospital psychiatry only.......CONCLUSIONS: Clinicians should be more observant on manic symptoms in children and adolescents who at first glance present with transient psychosis, reaction to stress/adjustment disorder or with behavioral and emotional disorders with onset during childhood or adolescents (F90-98) and follow these patients more closely...

  11. Dissecting bipolar disorder complexity through epigenomic approach.

    Science.gov (United States)

    Ludwig, B; Dwivedi, Y

    2016-11-01

    In recent years, numerous studies of gene regulation mechanisms have emerged in neuroscience. Epigenetic modifications, described as heritable but reversible changes, include DNA methylation, DNA hydroxymethylation, histone modifications and noncoding RNAs. The pathogenesis of psychiatric disorders, such as bipolar disorder, may be ascribed to a complex gene-environment interaction (G × E) model, linking the genome, environmental factors and epigenetic marks. Both the high complexity and the high heritability of bipolar disorder make it a compelling candidate for neurobiological analyses beyond DNA sequencing. Questions that are being raised in this review are the precise phenotype of the disorder in question, and also the trait versus state debate and how these concepts are being implemented in a variety of study designs.

  12. Aqueous based asymmetrical-bipolar electrochemical capacitor with a 2.4 V operating voltage

    Science.gov (United States)

    Wu, Haoran; Lian, Keryn

    2018-02-01

    A novel asymmetrical-bipolar electrochemical capacitor system leveraging the contributions of a Zn-CNT asymmetrical electrode and a KOH-H2SO4 dual-pH electrolyte was developed. The positive and negative electrodes operated in electrolytes with different pH, exploiting the maximum potential of both electrodes, which led to a cell voltage of 2.4 V. The potential tracking of both electrodes revealed that the Zn negative electrode could maintain a potential at -1.2 V, while the CNT positive electrode can be charged to +1.2 V without significant irreversible reactions. A bipolar ion exchange membrane has effectively separated the acid and alkaline from neutralization, which resulted in stable performance of the device with capacitance retention of 94% and coulombic efficiency of 99% over 10,000 cycles. This asymmetrical-bipolar design overcomes the thermodynamic limit of water decomposition, opening a new avenue towards high energy and high power density aqueous-based ECs.

  13. Climatic factors and bipolar affective disorder

    DEFF Research Database (Denmark)

    Christensen, Ellen Margrethe; Larsen, Jens Knud; Gjerris, Annette

    2008-01-01

    significant correlation between mean HAM-D(17) scores and change in mean and maximum temperature, and non-statistical significant correlations between mean MAS scores and rainfall plus atmospheric pressure, and non-statistical significant correlations between mean HAM-D(17) scores and hours of sunshine...... and cloudiness. Though meteorological factors may have an impact on triggering new episodes in bipolar patients, they do not constitute a dominant cause....

  14. Psychoeducation for bipolar disorder: A discourse analysis.

    Science.gov (United States)

    Wilson, Lynere; Crowe, Marie; Scott, Anne; Lacey, Cameron

    2018-02-01

    Psychoeducation has become a common intervention within mental health settings. It aims to increase people's ability to manage a life with a long-term illness. For people with bipolar disorder, psychoeducation is one of a range of psychosocial interventions now considered part of contemporary mental health practice. It has taken on a 'common sense' status that results in little critique of psychoeducation practices. Using a published manual on psychoeducation and bipolar disorder as its data, Foucauldian discourse analysis was used in the present study for a critical perspective on psychoeducation in order to explore the taken-for-granted assumptions on which it is based. It identifies that the text produces three key subject positions for people with bipolar disorder. To practice self-management, a person must: (i) accept and recognize the authority of psychiatry to know them; (ii) come to see that they can moderate themselves; and (iii) see themselves as able to undertake a reflexive process of self-examination and change. These findings highlight the circular and discursive quality to the construct of insight that is central to how psychoeducation is practiced. Using Foucault's construct of pastoral power, it also draws attention to the asymmetrical nature of power relations between the clinician and the person with bipolar disorder. An effect of the use of medical discourse in psychoeducation is to limit its ability to work with ambivalence and contradiction. A critical approach to psychotherapy and education offers an alternate paradigm on which to basis psychoeducation practices. © 2017 Australian College of Mental Health Nurses Inc.

  15. Bipolarity and Ambivalence in Landscape Architecture

    OpenAIRE

    Koh, J.

    2010-01-01

    Our discipline of landscape architecture contains bipolarity, not only in terms of landscape and architecture but also because the idea of landscape is both aesthetic and scientific. Furthermore, within landscape architecture there is a gap between design (as implied by architecture) and planning (implying land-use plan and policy orientation) on one hand, and a similar gap between design (associated with artistic activity, concerned with aesthetics as well as science) and research (considere...

  16. Smartphone based treatment in bipolar disorder

    DEFF Research Database (Denmark)

    Faurholt-Jepsen, M; Frost, M.; Bardram, J.E.

    2016-01-01

    During this symposium, results from a randomized controlled trial investigating the effect of smartphone based electronic self-monitoring on the severity of depressive and manic symptoms will be presented and discussed.Further, we will present and discuss the use of automatically generated...... objective smartphone data on behavioral activities (eg social activities, mobility and physical activity) as electronic biomarkers of illness activity in bipolar disorder....

  17. Bipolar disorder, a precursor of Parkinson's disease?

    Directory of Open Access Journals (Sweden)

    Tânia M.S. Novaretti

    Full Text Available ABSTRACT Parkinson's disease is a neurodegenerative disorder predominantly resulting from dopamine depletion in the substantia nigra pars compacta. Some psychiatric disorders may have dopaminergic dysfunction as their substrate. We describe a well-documented case of Parkinson's disease associated with Bipolar Disorder. Although there is some knowledge about the association between these diseases, little is known about its pathophysiology and correlation. We believe that among various hypotheses, many neurotransmitters are linked to this pathophysiology.

  18. The relationship between bipolar disorder and biological rhythms.

    Science.gov (United States)

    Gonzalez, Robert

    2014-04-01

    Rhythm disruption is a core feature of bipolar disorder and it has been hypothesized that disturbances of the circadian timing system play a fundamental role in the etiology of the disorder. We sought to investigate (1) theoretical models for biological rhythm disruptions in bipolar disorder, (2) physiological disturbances of biological rhythms in bipolar disorder, (3) clinical and therapeutic implications of biological rhythm disturbances in bipolar disorder, and (4) associations between circadian gene variations and bipolar disorder. PubMed database was searched systematically for articles that were published on or before May 5, 2013, and were written in English using the terms bipolar disorder, clock genes, endogenous clock, molecular clock, biological rhythms, circadian, suprachiasmatic nucleus, circadian rhythm, melatonin, and sleep. Seventy-four articles highlighting the objectives were included in the review. Data regarding exploring the association between bipolar disorder and circadian and chronobiological phenomena were reviewed and findings summarized. The literature reviewed suggests that circadian rhythm disturbance may be a feature of bipolar disorder. In toto, the literature suggests that circadian rhythm disturbances may be a feature of bipolar disorder. This area of research has received theoretical consideration as playing a significant role in the pathophysiology of the illness but has been understudied to this point. Further research in the field is warranted. © Copyright 2014 Physicians Postgraduate Press, Inc.

  19. Early Maladaptive Schemas in the risk for bipolar spectrum disorders.

    Science.gov (United States)

    Hawke, Lisa D; Provencher, Martin D; Arntz, Arnoud

    2011-10-01

    The hypomanic personality style is a risk factor for bipolar spectrum disorders and shares many cognitive and affective features with the bipolar spectrum. Schema theory may serve as a unifying theory that would explain many of these features. This study is an exploratory investigation of Early Maladaptive Schemas (EMSs) in association with the hypomanic personality and bipolar spectrum risk. A sample of 966 participants completed the Young Schema Questionnaire, the Hypomanic Personality Scale and the Patient Health Questionnaire. Associations were investigated using univariate and multivariate analyses. Participants deemed at risk of developing a bipolar disorder (N=107) were compared to low-risk controls (N=681). The Entitlement/Grandiosity and Insufficient Self-Control/Self-Discipline positively predicted the risk of developing a bipolar disorder, while Emotional Inhibition negatively predicted risk. High-risk participants demonstrated higher mean scores on all EMSs except Emotional Inhibition. These three EMSs, combined with Vulnerability to Harm or Illness, significantly predicted group membership. A bipolar spectrum EMS profile was identified, consisting of Entitlement/Grandiosity, Insufficient Self-Control/Self-Discipline and the absence of Emotional Inhibition. These EMSs are highly consistent with characteristics of the bipolar spectrum. This study supports the application of schema theory to the hypomanic personality and bipolar spectrum. Future research should explore the possible interaction between EMSs, life events and affective symptoms and the applicability of schema therapy to the bipolar spectrum. Crown Copyright © 2011. Published by Elsevier B.V. All rights reserved.

  20. Theory of mind deficits in bipolar affective disorder.

    Science.gov (United States)

    Kerr, Natalie; Dunbar, Robin I M; Bentall, Richard P

    2003-02-01

    Bipolar affective disorder patients often show cognitive deficits that are similar to those found in schizophrenia patients. Theory of mind (the ability to understand others' mental states) is compromised in currently ill schizophrenia patients. This study aimed to establish whether similar deficits are found in bipolar patients. We measured theory of mind ability in 20 bipolar-manic patients, 15 bipolar-depressed patients, 13 bipolar patients in remission and 15 normal controls. The task, which controlled for memory and comprehension, had previously been used in a study of schizophrenia patients. Impaired performance on theory of mind was found for both bipolar-depressed and bipolar-manic patients, even when memory was controlled for. No impairment was observed in the remitted patients. The manic patients scored lower than the remitted patients on a brief measure of intelligence; no other group differences in IQ were significant. Theory of mind deficits are found in currently symptomatic bipolar patients. These findings add to growing evidence that common mechanisms may contribute to bipolar affective disorder and schizophrenia.

  1. Coping and personality in older patients with bipolar disorder.

    Science.gov (United States)

    Schouws, Sigfried N T M; Paans, Nadine P G; Comijs, Hannie C; Dols, Annemiek; Stek, Max L

    2015-09-15

    Little is known about coping styles and personality traits in older bipolar patients. Adult bipolar patients show a passive coping style and higher neuroticism scores compared to the general population. Our aim is to investigate personality traits and coping in older bipolar patients and the relationship between coping and personality. 75 Older patients (age > 60) with bipolar I or II disorder in a euthymic mood completed the Utrecht Coping List and the NEO Personality Inventory FFI and were compared to normative data. Older bipolar patients show more passive coping styles compared to healthy elderly. Their personality traits are predominated by openness, in contrast conscientiousness and altruism are relatively sparse. Neuroticism was related to passive coping styles, whereas conscientiousness was related to an active coping style. Older bipolar patients have more passive coping styles. Their personality is characterized by openness and relatively low conscientiousness and altruism. Our sample represents a survival cohort; this may explain the differences in personality traits between older patients in this study and in adult bipolar patients in other studies. The association between coping styles and personality traits is comparable to reports of younger adult patients with bipolar disorder. Longitudinal studies are warranted to explore if coping and personality change with ageing in bipolar patients and to determine which coping style is most effective in preventing mood episodes. Copyright © 2015 Elsevier B.V. All rights reserved.

  2. "Is it menopause or bipolar?": a qualitative study of the experience of menopause for women with bipolar disorder.

    Science.gov (United States)

    Perich, Tania; Ussher, Jane; Parton, Chloe

    2017-11-16

    Menopause can be a time of change for women and may be marked by disturbances in mood. For women living with a mental illness, such as bipolar disorder, little is known about how they experience mood changes during menopause. This study aimed to explore how women with bipolar disorder constructed mood changes during menopause and how this impacted on treatment decisions. Semi-structured interviews were undertaken with fifteen women who reported they had been diagnosed with bipolar disorder. Data was analysed using thematic analysis guided by a social constructionist framework. Themes identified included 'Constructions of mood change: menopause or bipolar disorder?',' Life events, bipolar disorder and menopause coming together'; 'Treatment choices for mood change during menopause'. The accounts suggested that women related to the experience of mood changes during menopause through the lens of their existing framework of bipolar disorder, with implications for understanding of self and treatment choices.

  3. Recurrence and Relapse in Bipolar Mood Disorder

    Directory of Open Access Journals (Sweden)

    S Gh Mousavi

    2004-06-01

    Full Text Available Background: Despite the effectiveness of pharmacotherapy in acute phase of bipolar mood disorder, patients often experience relapses or recurrent episodes. Hospitalization of patients need a great deal of financial and humanistic resources which can be saved through understanding more about the rate of relapse and factors affecting this rate. Methods: In a descriptive analytical study, 380 patients with bipolar disorder who were hospitalized in psychiatric emergency ward of Noor hospital, Isfahan, Iran, were followed. Each patient was considered for; the frequency of relapse and recurrence, kind of pharmachotherapy, presence of psychotherapeutic treatments, frequency of visits by psychiatrist and the rank of present episode. Results: The overall prevalence of recurrence was 42.2%. Recurrence was lower in patients using lithium carbonate or sodium valproate or combined therapy (about 40%, compared to those using carbamazepine (80%. Recurrence was higher in patients treated with only pharmacotherapy (44.5% compared to those treated with both pharmacotherapy and psychotherapy (22.2%. Patients who were visited monthy by psychiatrist had lower rate of recurrence compared to those who had irregular visits. Conclusion: The higher rate of recurrence observed in carbamazepine therapy may be due to its adverse reactions and consequently poor compliance to this drug. Lower rates of recurrence with psychotherapy and regular visits may be related to the preventive effects of these procedures and especially to the effective management of stress. Keywords: Bipolar Mood Disorder, Recurrence, Relapse.

  4. Prescribing trends of antidepressants in bipolar depression.

    Science.gov (United States)

    Zarate, C A; Tohen, M; Baraibar, G; Kando, J C; Mirin, J

    1995-06-01

    This study utilizing pharmacoepidemiologic methods was undertaken to determine the prescribing patterns of antidepressants particularly in bipolar depression. From pharmacy records of the McLean Hospital, the number of patients receiving antidepressants and given electroconvulsive therapy (ECT) from June 1, 1987, to May 8, 1993, was determined. We later linked these data bases with patients who were diagnosed with DSM-III-R bipolar depression (296.5) during the same period of time. During the 6-year period, it was determined that 3829 inpatients had received tricyclic antidepressants (TCAs), 2981 fluoxetine, 2603 trazodone, 809 bupropion, 743 monoamine oxidase inhibitors (MAOIs), 592 stimulants, 588 sertraline, 48 paroxetine, and 894 ECT. There were significant increases over time in prescriptions of MAOIs compared with fluoxetine (chi 2 = 14.36, p = .006), and bupropion compared with TCAs (chi 2 = 6.45, p = .04). There was a trend for bupropion to be prescribed more over time compared with fluoxetine (chi 2 = 5.09, p = .08). There were no significant changes in the prescribing of other antidepressants or in the use of ECT. At our center, prescribing of bupropion and MAOIs in bipolar depression has increased significantly. This may be related to the reports in the literature of the low switch rates to mania with the use of these drugs.

  5. Bipolar magnetic semiconductor in silicene nanoribbons

    Science.gov (United States)

    Farghadan, Rouhollah

    2017-08-01

    A theoretical study was presented on generation of spin polarization in silicene nanoribbons using the single-band tight-binding approximation and the non-equilibrium Green's function formalism. We focused on the effect of electric and exchange magnetic fields on the spin-filter capabilities of zigzag-edge silicene nanoribbons in the presence of the intrinsic spin-orbit interaction. The results show that a robust bipolar magnetic semiconductor with controllable spin-flip and spin-conserved gaps can be obtained when exchange magnetic and electric field strengths are both larger than the intrinsic spin-orbit interaction. Therefore, zigzag silicene nanoribbons could act as bipolar and perfect spin filter devices with a large spin-polarized current and a reversible spin polarization in the vicinity of the Fermi energy. We also investigated the effect of edge roughness and found that the bipolar magnetic semiconductor features are robust against edge disorder in silicene nanoribbon junctions. These results may be useful in multifunctional spin devices based on silicene nanoribbons.

  6. Studies of anticipation in bipolar affective disorder.

    Science.gov (United States)

    Lange, Kezia J; McInnis, Melvin G

    2002-03-01

    Anticipation refers to the increase in disease severity or decrease in age of onset in successive generations. The concept evolved from the theories and dogma of degeneration that were pervasive in psychiatry and medicine in the late 19th century and into the early 20th century. The term was set aside with the criticism of geneticist Lionel Penrose, who argued that anticipation was the result of ascertainment biases. The renewed interest in anticipation followed the identification of its molecular genetic basis in the form of unstable trinucleotide repeats. Subsequently, several diseases have been studied clinically for the presence of anticipation. Although anticipation has been identified in many diseases, including bipolar disorder, only diseases showing a pattern of progressive neurodegeneration have been associated with unstable trinucleotide repeats. This review summarizes the research on anticipation in bipolar disorder and other secular trends in the patterns of the illness such as the cohort effect. The changing nature of bipolar disorder is likely to be a result of combined influences from several genes, some of which are likely to be in a state of flux, as well as environmental or cultural forces that converge to give the clinical picture of anticipation.

  7. Psychopathological characteristics of bipolar and unipolar depression - potential indicators of bipolarity.

    Science.gov (United States)

    Motovsky, Branislav; Pecenak, Jan

    2013-03-01

    Establishing whether a depressive episode is part of a unipolar or bipolar disorder is essential for treatment planning. Over recent years, a growing number of publications have discussed psychopathological characteristics that might serve as indicators of bipolarity in patients with a history of depression dominated by unipolar symptoms. Our primary aim was to verify the adequacy of these indicators in contributing to a precise diagnosis in everyday clinical practice. We investigated 104 patients diagnosed with major depressive episode at the time of examination. 52 patients had major depressive disorder and 52 patients had bipolar disorder. The patients were then assessed for the presence of potential bipolarity indicators: psychomotor slowing, self-view (self-blaming, feelings of worthlessness), hypersomnia, increased appetite, leaden paralysis/loss of physical energy, weight increase, interpersonal sensitivity, and early morning insomnia, using the Inventory of Depressive Symptomatology. We analysed the correlations between these indicators and the presence of unipolar or bipolar affective disorder. Psychomotor slowing, self-blaming/feelings of worthlessness, increased appetite, leaden paralysis/loss of physical energy, and weight increase were significantly more frequent in bipolar depression than in unipolar depression (p<0.05). Early morning insomnia was significantly more frequent in unipolar depression (p<0.05). There was no statistically significant correlation between hypersomnia or interpersonal sensitivity and either of the affective disorders. It would be worthwhile identifying the relative importance of clinical indicators for probable BP in large-scale prospective studies. These would contribute to the better diagnostic assessment of major depressive episodes and therapeutic decision-making.

  8. Cognitive vulnerability to bipolar disorder in offspring of parents with bipolar disorder.

    Science.gov (United States)

    Pavlickova, Hana; Turnbull, Oliver; Bentall, Richard P

    2014-11-01

    Bipolar disorder is a highly heritable illness, with a positive family history robustly predictive of its onset. It follows that studying biological children of parents with bipolar disorder may provide information about developmental pathways to the disorder. Moreover, such studies may serve as a useful test of theories that attribute a causal role in the development of mood disorders to psychological processes. Psychological style (including self-esteem, coping style with depression, domain-specific risk-taking, sensation-seeking, sensitivity to reward and punishment, and hypomanic personality and cognition) was assessed in 30 offspring of bipolar parents and 30 children of well parents. Parents of both child groups completed identical assessments. Although expected differences between parents with bipolar disorder and well parents were detected (such as low self-esteem, increased rumination, high sensitivity to reward and punishment), offspring of bipolar parents were, as a group, not significantly different from well offspring, apart from a modest trend towards lower adaptive coping. When divided into affected and non-affected subgroups, both groups of index children showed lower novelty-seeking. Only affected index children showed lower self-esteem, increased rumination, sensitivity to punishment, and hypomanic cognitions. Notably, these processes were associated with symptoms of depression. Psychological abnormalities in index offspring were associated with having met diagnostic criteria for psychiatric illnesses and the presence of mood symptoms, rather than preceding them. Implications of the present findings for our understanding of the development of bipolar disorder, as well as for informing early interventions, are discussed. © 2014 The British Psychological Society.

  9. Bipolar II compared with bipolar I disorder: baseline characteristics and treatment response to quetiapine in a pooled analysis of five placebo-controlled clinical trials of acute bipolar depression.

    Science.gov (United States)

    Datto, Catherine; Pottorf, William J; Feeley, Louisa; LaPorte, Scott; Liss, Charlie

    2016-01-01

    Bipolar I and II represent the most common and severe subtypes of bipolar disorder. Although bipolar I disorder is relatively well studied, the clinical characteristics and response to treatment of patients with bipolar II disorder are less well understood. To compare the severity and burden of illness of patients with bipolar II versus bipolar I disorder, baseline demographic, clinical, and quality of life data were examined in 1900 patients with bipolar I and 973 patients with bipolar II depression, who were enrolled in five similarly designed clinical placebo-controlled trials of quetiapine immediate-release and quetiapine extended-release. Acute (8 weeks) response to treatment was also compared by assessing rating scale scores, including Montgomery-Åsberg depression rating scale, Hamilton rating scale for anxiety, Young mania rating scale, and clinical global impression-severity scores, in the bipolar I and II populations in the same pooled database. Patients with bipolar I and bipolar II depression were similar in demographics, baseline rating scale scores (depression, anxiety, mania, and quality of life), and mood episode histories. Symptom improvements in response to quetiapine were greater versus comparators (lithium, paroxetine, and placebo) at 4 and 8 weeks in both bipolar I and II patients. Patients with the bipolar II subtype initially showed slower responses to all treatments, but, by 8 weeks, attained similar symptom improvement as patients with bipolar I depression. Pooled analysis of five clinical trials of quetiapine demonstrated that patients with bipolar II depression have a similar burden of illness and quality of life to patients with bipolar I. Bipolar II patients consistently showed a slower response to treatments than bipolar I patients, but, after 8 weeks of treatment with quetiapine, symptom improvements were similar between bipolar I and II disorder subtypes.

  10. Efficient treatment of aniline containing wastewater in bipolar membrane microbial electrolysis cell-Fenton system.

    Science.gov (United States)

    Li, Xiaohu; Jin, Xiangdan; Zhao, Nannan; Angelidaki, Irini; Zhang, Yifeng

    2017-08-01

    Aniline-containing wastewater can cause significant environmental problems and threaten the humans's life. However, rapid degradation of aniline with cost-efficient methods remains a challenge. In this work, a novel microbial electrolysis cell with bipolar membrane was integrated with Fenton reaction (MEC-Fenton) for efficient treatment of real wastewater containing a high concentration (4460 ± 52 mg L-1) of aniline. In this system, H2O2 was in situ electro-synthesized from O2 reduction on the graphite cathode and was simultaneously used as source of OH for the oxidation of aniline wastewater under an acidic condition maintained by the bipolar membrane. The aniline was effectively degraded following first-order kinetics at a rate constant of 0.0166 h-1 under an applied voltage of 0.5 V. Meanwhile, a total organic carbon (TOC) removal efficiency of 93.1 ± 1.2% was obtained, revealing efficient mineralization of aniline. The applicability of bipolar membrane MEC-Fenton system was successfully demonstrated with actual aniline wastewater. Moreover, energy balance showed that the system could be a promising technology for removal of biorefractory organic pollutants from wastewaters. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Sleep architecture in ziprasidone-treated bipolar depression: a pilot study.

    Science.gov (United States)

    Baskaran, Anusha; Summers, Dave; Willing, Stephanie Lm; Jokic, Ruzica; Milev, Roumen

    2013-06-01

    This study investigated the effect of ziprasidone augmentation therapy on sleep architecture in bipolar depression. We conducted a double-blind, randomized, placebo-controlled clinical pilot trial of ziprasidone versus placebo in Diagnostic and Statistical Manual of Mental Disorders, fourth edition bipolar disorder with current major depressive episode. The effects during acute (2-5 days) and continuation treatment (28-31 days) were measured. Main outcomes were sleep architecture variables including rapid eye movement sleep (REM) and slow wave sleep (SWS) measured by polysomnography. Secondary outcomes included subjective sleep quality measures and illness severity measures including the 17-item Hamilton Depression Rating Scale (HAMD-17), Montgomery Asberg Depression Rating Scale (MADRS), Hamilton Anxiety Rating Scale (HAMA) and Clinical Global Illness Severity (CGI-S) scores. The completer analysis comprised of 14 patients (ziprasidone, N = 8 and placebo, N = 6). Latency to REM, duration of SWS, duration of stage 2 sleep, total sleep time, onset to sleep latency, number of awakenings and overall sleep efficiency significantly improved in ziprasidone-treated participants over placebo. CGI-S and HAMA scores also significantly improved. No significant difference between treatment groups was seen on the HAMD-17, MADRS or in self-reported sleep quality. Increase in SWS duration significantly correlated with improvement in CGI-S, however, this finding did not withstand Bonferroni correction. Adjunctive ziprasidone treatment alters sleep architecture in patients with bipolar depression, which may partially explain its mechanism of action and merits further investigation.

  12. Bipolar disorder and age-related functional impairment Prejuízo funcional associado à idade e transtorno bipolar

    Directory of Open Access Journals (Sweden)

    Alice Aita Cacilhas

    2009-12-01

    Full Text Available OBJECTIVE: Although bipolar disorder is a major contributor to functional impairment worldwide, an independent impact of bipolar disorder and ageing on functioning has yet to be demonstrated. The objective of the present study was to evaluate the effect of bipolar disorder on age-related functional status using matched controls as a standard. METHOD: One-hundred patients with bipolar disorder and matched controls were evaluated for disability. Age-related effects controlled for confounders were cross-sectionally evaluated. RESULTS: Patients were significantly more impaired than controls. Regression showed effects for aging in both groups. The effect, size, however, was significantly stronger in patients. CONCLUSION: Bipolar disorder was an important effect modifier of the age impact on functioning. While a longitudinal design is needed to effectively demonstrate this different impact, this study further depicts bipolar disorder as a chronic and progressively impairing illness.OBJETIVO: O transtorno bipolar é responsável por importante parcela do prejuízo funcional ao redor do mundo. Um efeito independente do transtorno bipolar e da idade no funcionamento ainda não foi demonstrado. O presente estudo tem o objetivo de avaliar o efeito do transtorno bipolar no prejuízo funcional relacionado à idade, com controles pareados como padrão. MÉTODO: Cem pacientes com transtorno bipolar e controles pareados foram avaliados para incapacidade. Efeitos relacionados à idade, com controle para confundidores, foram investigados. RESULTADOS: Pacientes tiveram significativamente mais prejuízo que controles. A regressão mostrou efeito para a idade em ambos os grupos, e o efeito foi significativamente mais forte nos pacientes. CONCLUSÃO: O transtorno bipolar foi um importante modificador de efeito no impacto da idade no funcionamento. Enquanto um desenho de estudo longitudinal é necessário para efetivamente demonstrar este impacto diferencial, este

  13. Toward the definition of a bipolar prodrome: Dimensional predictors of bipolar spectrum disorder in at-risk youth

    Science.gov (United States)

    Hafeman, Danella M.; Merranko, John; Axelson, David; Goldstein, Benjamin I.; Goldstein, Tina; Monk, Kelly; Hickey, Mary Beth; Sakolsky, Dara; Diler, Rasim; Iyengar, Satish; Brent, David; Kupfer, David; Birmaher, Boris

    2016-01-01

    Objective We aimed to assess dimensional symptomatic predictors of new-onset bipolar spectrum disorder in youth at familial risk of bipolar disorder (“at-risk” youth). Method Offspring aged 6–18 of parents with bipolar-I/II disorder (n=391) and offspring of community controls (n=248) were recruited without regard to non-bipolar psychopathology. At baseline, 8.4% (33/391) of offspring of bipolar parents had bipolar spectrum; 14.7% (44/299) of offspring with follow-up developed new-onset bipolar spectrum (15 with bipolar-I/II) over eight years. Scales collected at baseline and follow-up were reduced using factor analyses; factors (both at baseline and visit proximal to conversion or last contact) were then assessed as predictors of new-onset bipolar spectrum. Results Relative to community control offspring, at-risk and bipolar offspring had higher baseline levels of anxiety/depression, inattention/disinhibition, externalizing, subsydromal manic, and affective lability symptoms (pbipolar spectrum were: baseline anxiety/depression, baseline and proximal affective lability, and proximal subsyndromal manic symptoms (pbipolar spectrum, manic symptoms increased up to the point of conversion. A path analysis supported the hypothesized model that affective lability at baseline predicted new-onset bipolar spectrum, in part, through increased manic symptoms at the visit prior to conversion; earlier parental age of mood disorder onset also significantly increased risk of conversion (pbipolar spectrum, those with all risk factors had a 49% predicted chance of conversion. Conclusions Dimensional measures of anxiety/depression, affective lability, and mania are important predictors of new-onset bipolar spectrum in this population of at-risk youth. These symptoms emerged from among numerous other candidates, underscoring the potential clinical and research utility of these findings. PMID:26892940

  14. Bipolar polygenic loading and bipolar spectrum features in major depressive disorder.

    Science.gov (United States)

    Wiste, Anna; Robinson, Elise B; Milaneschi, Yuri; Meier, Sandra; Ripke, Stephan; Clements, Caitlin C; Fitzmaurice, Garrett M; Rietschel, Marcella; Penninx, Brenda W; Smoller, Jordan W; Perlis, Roy H

    2014-09-01

    Family and genetic studies indicate overlapping liability for major depressive disorder and bipolar disorder. The purpose of the present study was to determine whether this shared genetic liability influences clinical presentation. A polygenic risk score for bipolar disorder, derived from a large genome-wide association meta-analysis, was generated for each subject of European-American ancestry (n = 1,274) in the Sequential Treatment Alternatives to Relieve Depression study (STAR*D) outpatient major depressive disorder cohort. A hypothesis-driven approach was used to test for association between bipolar disorder risk score and features of depression associated with bipolar disorder in the literature. Follow-up analyses were performed in two additional cohorts. A generalized linear mixed model including seven features hypothesized to be associated with bipolar spectrum illness was significantly associated with bipolar polygenic risk score [F = 2.07, degrees of freedom (df) = 7, p = 0.04]. Features included early onset, suicide attempt, recurrent depression, atypical depression, subclinical mania, subclinical psychosis, and severity. Post-hoc univariate analyses demonstrated that the major contributors to this omnibus association were onset of illness at age ≤ 18 years [odds ratio (OR) = 1.2, p = 0.003], history of suicide attempt (OR = 1.21, p = 0.03), and presence of at least one manic symptom (OR = 1.16, p = 0.02). The maximal variance in these traits explained by polygenic score ranged from 0.8% to 1.1%. However, analyses in two replication cohorts testing a five-feature model did not support this association. Bipolar genetic loading appeared to be associated with bipolar-like presentation in major depressive disorder in the primary analysis. However, the results were at most inconclusive because of lack of replication. Replication efforts were challenged by different ascertainment and assessment strategies in the different cohorts. The methodological approach

  15. Transtorno afetivo bipolar: um enfoque transcultural Transcultural aspects of bipolar disorder

    OpenAIRE

    Marsal Sanches; Miguel Roberto Jorge

    2004-01-01

    Considerando-se que existem diferenças importantes na maneira como as emoções são vivenciadas e expressas em diferentes culturas, a apresentação e o manejo do transtorno afetivo bipolar sofrem influência de fatores culturais. O presente artigo realiza uma breve revisão da evidência referente aos aspectos transculturais do transtorno bipolar.Cultural variations in the expression of emotions have been described. Consequently, there are cross-cultural influences on the diagnosis and management o...

  16. Rapid Prototyping

    Science.gov (United States)

    1999-01-01

    Javelin, a Lone Peak Engineering Inc. Company has introduced the SteamRoller(TM) System as a commercial product. The system was designed by Javelin during a Phase II NASA funded small commercial product. The purpose of the invention was to allow automated-feed of flexible ceramic tapes to the Laminated Object Manufacturing rapid prototyping equipment. The ceramic material that Javelin was working with during the Phase II project is silicon nitride. This engineered ceramic material is of interest for space-based component.

  17. Biological treatment of acute agitation or aggression with schizophrenia or bipolar disorder in the inpatient setting.

    Science.gov (United States)

    Correll, Christoph U; Yu, Xin; Xiang, Yutao; Kane, John M; Masand, Prakash

    2017-05-01

    Schizophrenia and bipolar disorders are chronic illnesses that commonly present with symptoms of acute agitation and aggression. These symptoms must be managed rapidly to prevent potential harm to the patient and others, including their caregivers, peers, and health care workers. A number of treatment options are available to clinicians to manage acute agitation and aggression, including non-pharmacologic behavioral and environmental de-escalation strategies, as well as biological treatment options such as pharmacologic agents and electroconvulsive therapy. We summarize the available biological treatment options for patients with schizophrenia or bipolar disorder presenting with acute agitation or aggression in the inpatient setting, focusing on antipsychotics. The following searches were used in PubMed to obtain the most relevant advances in treating schizophrenia or bipolar disorder with acute agitation and aggression: (agitation, agitated, aggression, aggressive, hostile, hostility, violent, or violence) and (schizophr*, psychosis, psychot*, psychos*, mania, manic, or bipolar) and (*pharmacologic, antipsychotic*, neuroleptic*, antiepileptic*, anti-seizure*, mood stabilizer*, lithium, benzodiazepine*, beta blocker, beta-blocker, alpha2, alpha-2, *histamine*, electroconvulsive, ECT, shock, or transcranial). Individual searches were performed for each drug class. The studies were limited to peer-reviewed, English-language, and human studies. Most were placebo-controlled randomized controlled trials (RCTs) or meta-analyses. Among pharmacologic agents, antipsychotics, benzodiazepines, anticonvulsants, and lithium have been studied in randomized trials. Some typical and, more recently, atypical antipsychotics are available as both oral and short-acting intramuscular (IM) formulations, with 1 typical antipsychotic also available as an inhalable formulation. Among the pharmacologic agents studied in RCTs, atypical antipsychotics have the best evidence to support

  18. Negative Life Events in Children and Adolescents with Bipolar Disorder

    Science.gov (United States)

    Romero, Soledad; Birmaher, Boris; Axelson, David A.; Iosif, Ana-Maria; Williamson, Douglas E.; Gill, Mary Kay; Goldstein, Benjamin I.; Strober, Michael A.; Hunt, Jeffrey; Goldstein, Tina R.; Esposito-Smythers, Christianne; Iyengar, Satish; Ryan, Neal D.; Keller, Martin

    2010-01-01

    Objectives To study the relationship between negative life events and demographic and clinical variables in youth with bipolar I disorder, bipolar II disorder, and bipolar disorder not otherwise specified (NOS), as well as to compare the rates of life events in youth with bipolar disorder, depressive and/or anxiety disorders (DEP-ANX), and healthy controls. Methods Subjects included 446 youth, aged 7 to 17 years, meeting DSM-IV criteria for bipolar I, bipolar II, or an operationalized definition of bipolar disorder NOS, and were enrolled in the Course and Outcome of Bipolar Illness in Youth study. Subjects completed the Life Events Checklist. Sixty-five DEP-ANX and 65 healthy youth were obtained from previous studies using similar methodology. The study was conducted from October 2000 to July 2006. Results Older age, lower socioeconomic status, living with nonintact family, non-Caucasian race, anxiety, and disruptive disorders were associated with greater number of total negative life events. Specifically, increased independent, dependent, and uncertain negative life events were associated with lower socioeconomic status, nonintact family, and comorbid disruptive disorders. Increased independent negative life events were additionally associated with non-Caucasian race and comorbid anxiety disorders. Increased dependent and uncertain negative life events were also associated with older age. DEP-ANX youth reported a similar rate of negative life events as bipolar youth, and both groups had more negative life events than the healthy controls. Bipolar youth reported fewer total and dependent positive life events compared to DEP-ANX and healthy youths. Conclusions Similar to DEP-ANX youth, bipolar youth are exposed to excessive negative independent and dependent life events which may have implications in the long-term outcome and negative consequences associated with this disorder. PMID:19906349

  19. Differential function of Gγ13 in rod bipolar and ON cone bipolar cells

    Science.gov (United States)

    Ramakrishnan, Hariharasubramanian; Dhingra, Anuradha; Tummala, Shanti R; Fina, Marie E; Li, Jian J; Lyubarsky, Arkady; Vardi, Noga

    2015-01-01

    Key points The G-protein-mediated metabotropic glutamate receptor 6 (mGluR6) signalling cascade is critical for light responses in all retinal ON bipolar cells. The present study evaluates the role of G-protein subunit Gγ13 in ON bipolar cells by deleting the mouse Gng13 gene. Gγ13 is a partner of Gβ3 in all types of retinal ON bipolar cells, and contributes to generating the light response. Gγ13 also contributes to maintenance because, in its absence, the light response decreases with age. Three independent functionality assessments (i.e. light response as measured by electroretinogram b-waves, localization of GTPase activating proteins and deterioration of the light response with age) show that the contribution of Gγ13 is much greater in rod bipolar cells than in ON cone bipolar cells. Our data also suggest that the contribution of Gγ13 to coupling mGluR6 to its effector is smaller than its contribution to maintaining GTPase activating protein localization. Abstract Heterotrimeric G-proteins (comprising Gα and Gβγ subunits) are critical for coupling of metabotropic receptors to their downstream effectors. In the retina, glutamate released from photoreceptors in the dark activates metabotropic glutamate receptor 6 (mGluR6) receptors in ON bipolar cells; this leads to activation of Go, closure of transient receptor potential melastatin 1 channels and hyperpolarization of these cells. Go comprises Gαo, Gβ3 and a Gγ. The best Gγ candidate is Gγ13, although functional data to support this are lacking. Thus, we tested Gγ13 function by generating Gng13−/− knockout (KO) mice, recording electroretinograms (ERG) and performing immunocytochemical staining. The amplitude of scotopic ERG b-waves in KO mice was lower than in wild-type (WT) mice. Furthermore, in both KO and WT mice, the ERG b-wave decreased with age; this decrease was much more pronounced in KO mice. By contrast, the photopic ERG b-waves in KO mice were hardly affected at any age. In KO mice

  20. Bipolarity in depressive patients without histories of diagnosis of bipolar disorder and the use of the Mood Disorder Questionnaire for detecting bipolarity.

    Science.gov (United States)

    Kim, Byungsu; Wang, Hee Ryung; Son, Jung In; Kim, Chang Yoon; Joo, Yeon Ho

    2008-01-01

    The present study was performed to evaluate the frequency of bipolar disorders among patients (a) presenting with depressive episodes but (b) who have never been diagnosed with bipolar disorder (c) in routine clinical practice in Korean subjects and to identify which clinical features were helpful in discriminating bipolar patients from unipolar patients. In addition, authors assessed the practical use of the Mood Disorder Questionnaire (MDQ) to distinguish bipolar from unipolar disorder in these subjects and tested whether modifications of the MDQ scoring could improve its performance. We evaluated consecutive patients who satisfied the inclusion criteria of a current depressive episode, plus at least one previous depressive episode. Subjects were interviewed for diagnosis using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders IV after completing the MDQ. To improve assessment of hypomania history, the interviewer made strenuous efforts to explore a possible history of hypomania, and patient-derived data were supplemented by information from family members or close relatives. Fifty-nine patients (53.2%) were classified as having bipolar disorder, leaving a group of 52 (46.8%) with unipolar depression. Among bipolar disorders, 1.8% (n = 2) had bipolar I disorder; 29.7% (n = 33), bipolar II disorder; 6.3% (n = 7), bipolar III disorder (history of antidepressant-induced hypomania without spontaneous hypomanic episode); and 15.3% (n = 17), bipolar disorder not otherwise specified (1-3 days brief hypomania). Postpartum depression (relative risk [RR] [95% confidence interval {CI}], 2.00 [1.23-3.24]), early age of onset (RR [95% CI], 1.85 [1.30-2.64]), mood lability (RR [95% CI], 1.85 [1.30-2.64]), brief depressive episode (RR [95% CI], 1.66 (1.16-2.37]), bipolar family history (RR [95% CI], 1.62 [1.08-2.43]), history of suicide attempt (RR [95% CI], 1.47 (1.05-2.04]), and alcohol problem (RR [95% CI], 1.45 (1.04-2.02]) were

  1. Affective lability mediates the association between childhood trauma and suicide attempts, mixed episodes and co-morbid anxiety disorders in bipolar disorders.

    Science.gov (United States)

    Aas, M; Henry, C; Bellivier, F; Lajnef, M; Gard, S; Kahn, J-P; Lagerberg, T V; Aminoff, S R; Bjella, T; Leboyer, M; Andreassen, O A; Melle, I; Etain, B

    2017-04-01

    Many studies have shown associations between a history of childhood trauma and more severe or complex clinical features of bipolar disorders (BD), including suicide attempts and earlier illness onset. However, the psychopathological mechanisms underlying these associations are still unknown. Here, we investigated whether affective lability mediates the relationship between childhood trauma and the severe clinical features of BD. A total of 342 participants with BD were recruited from France and Norway. Diagnosis and clinical characteristics were assessed using the Diagnostic Interview for Genetic Studies (DIGS) or the Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I). Affective lability was measured using the short form of the Affective Lability Scale (ALS-SF). A history of childhood trauma was assessed using the Childhood Trauma Questionnaire (CTQ). Mediation analyses were performed using the SPSS process macro. Using the mediation model and covariation for the lifetime number of major mood episodes, affective lability was found to statistically mediate the relationship between childhood trauma experiences and several clinical variables, including suicide attempts, mixed episodes and anxiety disorders. No significant mediation effects were found for rapid cycling or age at onset. Our data suggest that affective lability may represent a psychological dimension that mediates the association between childhood traumatic experiences and the risk of a more severe or complex clinical expression of BD.

  2. Repeated Maxima of Sunspot Cycles

    Science.gov (United States)

    Krivodubskij, V.

    2015-12-01

    The explanation for the observed phenomenon of repeated maxima of sunspot cycles is proposed. Key roles in the proposed scenarioplay two tides of toroidal field from the lower base of the solar convection zone (SCZ) to the surface. Deep toroidal field is excited due to Ω-effectnear the bottom of the SCZ at the beginning of the cycle. Then this field is transported to the surface due to combined acting of magnetic buoyancy,magnetic ∇ρ-flow and turbulent diamagnetism in the equatorial domain. Over time the magnetic fragments can be seen as bipolar spots in themiddle latitudes in the "royal zone". This first wave of toroidal field, which is directed up, gives the main maximum activity spots. However, theunderlying toroidal field in the high-latitude polar domains at the beginning of the cycle is blocked by directed downward magnetic∇ρ-pumping and turbulent diamagnetism. Directed to the equator deep meridional flow replaces this field to the low latitudes (the equatorialdomain) during about 1 - 2 years. After that the turn of floating this "retarded" field to surface (second tide of toroidal field). Coming to the surfaceat low latitudes this second portion of toroidal field leads to second sunspot maximum.

  3. Bipolar diagnosis in China: Evaluating diagnostic confidence using the Bipolarity Index.

    Science.gov (United States)

    Ma, Yantao; Gao, Huimin; Yu, Xin; Si, Tianmei; Wang, Gang; Fang, Yiru; Liu, Zhening; Sun, Jing; Yang, Haichen; Wang, Xueyi; Li, Jing; Zhang, Yonghua; Sachs, Gary

    2016-09-15

    Diagnosis of bipolar disorder is inherently difficult. The goal of this study was to examine the utility and psychometric properties of the Bipolarity Index (BPx) in a population of patients treated in China. At nine Chinese health facilities participating in CAFÉ-BD, clinicians completed a standardized affective disorder evaluation for consecutive patients (N=615) with a clinical diagnosis of MDD and BPD and scored the Bipolarity Index. The investigators constructed ROC curves to determine the optimal cut off points to discriminate subjects in three clinical diagnostic groups: bipolar disorder (BPD), major depressive disorder (MDD) and healthy (no psychiatric diagnosis) controls (HC). This study is registered with ClinicalTrials.gov, number NCT02015143. 1) The cut-off score between the MDD and BPD groups was 42.0, with a sensitivity of 0.957 and specificity of 0.881 (Z=63.064, Pbipolar spectrum disorders. Further prospective study is necessary to determine if the BPx is useful in identifying subgroups among MDD subjects at high risk for conversion to BPD. Copyright © 2016 Elsevier B.V. All rights reserved.

  4. New types of bipolar fuzzy sets in -semihypergroups

    Directory of Open Access Journals (Sweden)

    Naveed Yaqoob

    2016-04-01

    Full Text Available The notion of bipolar fuzzy set was initiated by Lee (2000 as a generalization of the notion fuzzy sets and intuitionistic fuzzy sets, which have drawn attention of many mathematicians and computer scientists. In this paper, we initiate a study on bipolar ( , -fuzzy sets in -semihypergroups. By using the concept of bipolar ( , -fuzzy sets (Yaqoob and Ansari, 2013, we introduce the notion of bipolar ( , -fuzzy sub -semihypergroups (-hyperideals and bi--hyperideals and discuss some basic results on bipolar ( , -fuzzy sets in -semihypergroups. Furthermore, we define the bipolar fuzzy subset ,               and prove that if  ,       is a bipolar ( , -fuzzy sub -semihypergroup (resp., -hyperideal and bi--hyperideal of H; then ,               is also a bipolar ( , -fuzzy sub -semihypergroup (resp., -hyperideal and bi--hyperideal of H.

  5. Premorbid intelligence and educational level in bipolar and unipolar disorders

    DEFF Research Database (Denmark)

    Sørensen, Holger Jelling; Sæbye, Ditte; Urfer-Parnas, Annick

    2012-01-01

    Registry-based studies have found no or weak associations between premorbid intelligence and the broad entity of affective spectrum disorder, but none of the studies compared bipolar/unipolar subgroups.......Registry-based studies have found no or weak associations between premorbid intelligence and the broad entity of affective spectrum disorder, but none of the studies compared bipolar/unipolar subgroups....

  6. State-related alterations of gene expression in bipolar disorder

    DEFF Research Database (Denmark)

    Munkholm, Klaus; Vinberg, Maj; Berk, Michael

    2012-01-01

    studies, showing no alteration between bipolar disorder patients and control individuals. Conclusions:  There is evidence of some genes exhibiting state-related alterations in expression in bipolar disorder; however, this finding is limited by the lack of replication across studies. Further prospective...

  7. Seasonal variation of manic and depressive symptoms in bipolar disorder.

    Science.gov (United States)

    Akhter, Ahmed; Fiedorowicz, Jess G; Zhang, Tao; Potash, James B; Cavanaugh, Joseph; Solomon, David A; Coryell, William H

    2013-06-01

    Analyses of seasonal variation of manic and depressive symptoms in bipolar disorder in retrospective studies examining admission data have yielded conflicting results. We examined seasonal variation of mood symptoms in a prospective cohort with long-term follow-up: the Collaborative Depression Study (CDS). The CDS included participants from five academic centers with a prospective diagnosis of bipolar I or II disorder. The sample was limited to those who were followed for at least 10 years of annual or semi-annual assessments. Time series analyses and autoregressive integrated moving average (ARIMA) models were used to assess seasonal patterns of manic and depressive symptoms. A total of 314 individuals were analyzed (bipolar I disorder, n = 202; bipolar II disorder, n = 112), with both disorders exhibiting the lowest frequency of depressive symptoms in summer and the highest around the winter solstice, though the winter peak in symptoms was statistically significant only with bipolar I disorder. Variation of manic symptoms was more pronounced in bipolar II disorder, with a significant peak in hypomanic symptomatology in the months surrounding the fall equinox. Significant seasonal variation exists in bipolar disorder, with manic/hypomanic symptoms peaking around the fall equinox and depressive symptoms peaking in the months surrounding the winter solstice in bipolar I disorder. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. [Differences in Subjective Experience Between Unipolar and Bipolar Depression].

    Science.gov (United States)

    Fierro, Marco; Bustos, Andrés; Molina, Carlos

    2016-01-01

    It is important to make distinction between bipolar and unipolar depression because treatment and prognosis are different. Since the diagnosis of the two conditions is purely clinical, find symptomatic differences is useful. Find differences in subjective experience (first person) between unipolar and bipolar depression. Phenomenological-oriented qualitative exploratory study of 12 patients (7 with bipolar depression and 5 with unipolar depression, 3 men and 9 women). We used a semi-structured interview based on Examination of Anomalous Self-Experience (EASE). The predominant mood in bipolar depression is emotional dampening, in unipolar is sadness. The bodily experience in bipolar is of a heavy, tired body; an element that inserts between the desires of acting and performing actions and becomes an obstacle to the movement. In unipolar is of a body that feels more comfortable with the stillness than activity, like laziness of everyday life. Cognition and the stream of consciousness: in bipolar depression, compared with unipolar, thinking is slower, as if to overcome obstacles in their course. There are more difficult to understand what is heard or read. Future perspective: in bipolar depression, hopelessness is stronger and broader than in unipolar, as if the very possibility of hope was lost. Qualitative differences in predominant mood, bodily experience, cognition and future perspective were found between bipolar and unipolar depression. Copyright © 2015 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  9. Precursors in adolescence of adult-onset bipolar disorder.

    Science.gov (United States)

    Hiyoshi, Ayako; Sabet, Julia A; Sjöqvist, Hugo; Melinder, Carren; Brummer, Robert J; Montgomery, Scott

    2017-08-15

    Although the estimated contribution of genetic factors is high in bipolar disorder, environmental factors may also play a role. This Swedish register-based cohort study of men examined if physical and psychological characteristics in late adolescence, including factors previously linked with bipolar disorder (body mass index, asthma and allergy), are associated with subsequent bipolar disorder in adulthood. Unipolar depression and anxiety are analysed as additional outcomes to identify bipolar disorder-specific associations. A total of 213,693 men born between 1952 and 1956, who participated in compulsory military conscription assessments in late adolescence were followed up to 2009, excluding men with any psychiatric diagnoses at baseline. Cox regression estimated risk of bipolar disorder, depression and anxiety in adulthood associated with body mass index, asthma, allergy, muscular strength stress resilience and cognitive function in adolescence. BMI, asthma and allergy were not associated with bipolar disorder. Higher grip strength, cognitive function and stress resilience were associated with a reduced risk of bipolar disorder and the other disease outcomes. The sample consisted only of men; even though the characteristics in adolescence pre-dated disease onset, they may have been the consequence of prodromal disease. Associations with body mass index and asthma found by previous studies may be consequences of bipolar disorder or its treatment rather than risk factors. Inverse associations with all the outcome diagnoses for stress resilience, muscular strength and cognitive function may reflect general risks for these psychiatric disorders or intermediary factors. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. Metabolic syndrome in Tunisian bipolar I patients | Ezzaher | African ...

    African Journals Online (AJOL)

    Conclusions: Bipolar patients have high prevalence of metabolic syndrome which is associated with insulin resistance and an increase of uric acid values that raise the risk of cardiovascular disease. Keywords: bipolar disorder, metabolic syndrome, uric acid, insulin resistance. African Health Sciences 2011; 11(3): 414 - 420 ...

  11. Risperidone Mono - Therapy as Prophylaxis in Bipolar Affective Disorders

    OpenAIRE

    Trivedi, Mohit; Pinto, Denzil; Safeekh, A.T.

    2004-01-01

    Risperidone has been found to be useful in the treatment of acute bipolar disorders. This is a case report where risperidone mono therapy has been found to be effective in prophylaxis of bipolar affective disorder. The pharmacological and clinical implications of risperidone in the management of BPAD are discussed

  12. The poor prognosis of childhood-onset bipolar disorder

    NARCIS (Netherlands)

    Leverich, Gabriele S.; Post, Robert M.; Keck, Paul E.; Altshuler, Lori L.; Frye, Mark A.; Kupka, Ralph W.; Nolen, Willem A.; Suppes, Trisha; McElroy, Susan L.; Grunze, Heinz; Denicoff, Kirk; Moravec, Maria K. M.; Luckenbaugh, David

    Objective We examined age of onset of bipolar disorder as a potential course-of-iflness modifier with the hypothesis that early onset will engender more severe illness. Study design A total of 480 carefully diagnosed adult outpatients with bipolar disorder (mean age, 42.5 +/- 11.6 years) were

  13. Assymetric bipolar membranes in acid-base electrodialysis

    NARCIS (Netherlands)

    Wilhelm, F.G.; Punt, Ineke G.M.; van der Vegt, N.F.A.; Strathmann, H.; Wessling, Matthias

    2002-01-01

    In this experimental study, the influence of asymmetric bipolar membranes on the salt impurities in the acid and base product is investigated. The thickness of one, the other, or both ion-permeable layers of a bipolar membrane is increased. With increased layer thickness, the current-voltage curves

  14. Tailoring the interface layer of the bipolar membrane

    NARCIS (Netherlands)

    Balster, J.H.; Srinkantharajah, S.; Sumbharaju, R.; Punt, Ineke G.M.; Lammertink, Rob G.H.; Stamatialis, Dimitrios; Wessling, Matthias

    2010-01-01

    This work investigates various parameters affecting the water splitting of bipolar ion-exchange membranes. We show that the amount of functional groups and the water content of the interface layer have a strong influence on the bipolar membrane resistance. Use of anion exchange layers containing

  15. Family environment patterns in families with bipolar children.

    Science.gov (United States)

    Belardinelli, Cecilia; Hatch, John P; Olvera, Rene L; Fonseca, Manoela; Caetano, Sheila C; Nicoletti, Mark; Pliszka, Steven; Soares, Jair C

    2008-04-01

    We studied the characteristics of family functioning in bipolar children and healthy comparison children. We hypothesized that the family environment of bipolar children would show greater levels of dysfunction as measured by the Family Environment Scale (FES). We compared the family functioning of 36 families that included a child with DSM-IV bipolar disorder versus 29 comparison families that included only healthy children. All subjects and their parents were assessed with the K-SADS-PL interview. The parents completed the FES to assess their current family functioning. Multivariate analysis of variance was used to compare the family environment of families with and without offspring with bipolar disorder. Parents of bipolar children reported lower levels of family cohesion (pfamilies where a parent had a history of mood disorders compared to families where parents had no history of mood disorders. Length of illness in the affected child was inversely associated with family cohesion (r=-0.47, p=0.004). Due to the case-control design of the study, we cannot comment on the development of these family problems or attribute their cause specifically to child bipolar disorder. Families with bipolar children show dysfunctional patterns related to interpersonal interactions and personal growth. A distressed family environment should be addressed when treating children with bipolar disorder.

  16. Pediatric Bipolar Disorder: Evidence for Prodromal States and Early Markers

    Science.gov (United States)

    Luby, Joan L.; Navsaria, Neha

    2010-01-01

    Background: Childhood bipolar disorder remains a controversial but increasingly diagnosed disorder that is associated with significant impairment, chronic course and treatment resistance. Therefore, the search for prodromes or early markers of risk for later childhood bipolar disorder may be of great importance for prevention and/or early…

  17. The Enigma of Bipolar Disorder in Children and Adolescents

    Science.gov (United States)

    Hatchett, Gregory T.

    2009-01-01

    In the past decade, there has been a proliferation in the number of children and adolescents diagnosed with bipolar disorder. Except in rare cases, the young people who receive this diagnosis do not meet the strict diagnostic criteria for bipolar disorder I or II in the DSM-IV-TR. Many pediatric psychiatrists insist there are important development…

  18. Olfactocentric Paralimbic Cortex Morphology in Adolescents with Bipolar Disorder

    Science.gov (United States)

    Wang, Fei; Kalmar, Jessica H.; Womer, Fay Y.; Edmiston, Erin E.; Chepenik, Lara G.; Chen, Rachel; Spencer, Linda; Blumberg, Hilary P.

    2011-01-01

    The olfactocentric paralimbic cortex plays a critical role in the regulation of emotional and neurovegetative functions that are disrupted in core features of bipolar disorder. Adolescence is thought to be a critical period in both the maturation of the olfactocentric paralimbic cortex and in the emergence of bipolar disorder pathology. Together,…

  19. Pharmacological Management of Bipolar Disorder in a Youth with Diabetes

    Science.gov (United States)

    DelBello, Melissa P.; Correll, Christoph U.; Carlson, Gabrielle A.; Carlson, Harold E.; Kratochvil, Christopher J.

    2007-01-01

    In this article, four clinicians respond to the following case vignette: A 12-year-old girl with insulin-dependent diabetes presents for treatment of her newly diagnosed bipolar disorder. How would you address the bipolar disorder pharmacologically, and how would the presence of diabetes affect your selection of medication and clinical management?

  20. Bipolar Disorder in Children: Implications for Speech-Language Pathologists

    Science.gov (United States)

    Quattlebaum, Patricia D.; Grier, Betsy C.; Klubnik, Cynthia

    2012-01-01

    In the United States, bipolar disorder is an increasingly common diagnosis in children, and these children can present with severe behavior problems and emotionality. Many studies have documented the frequent coexistence of behavior disorders and speech-language disorders. Like other children with behavior disorders, children with bipolar disorder…